Abstract

To test the hypothesis that the combined birthweight deficit from smoking in twin gestation is significantly greater than previously described for singletons. Retrospective cohort study of White/Black live-born twins, 32 to 40 weeks of gestation, 1990 to 2005, Kansas City, MO. Data were analyzed by t-test, χ(2), linear and linear regression analyses. The cohort comprised 1190 twin pairs, 58% Whites and 55% ≥37 weeks. Smoking rate was 14.5% and similar by race (14.2% White vs 14.8%, P=0.772). The aggregate birthweight of twins of nonsmokers was greater, 5116 g ± 25 g vs 4870 g ± 59 g, P<0.001 (mean±s.d.) and the difference was 264 g (95% confidence interval, 156 to 372 g) after adjusting for other variables in linear regression analyses. Smoking-associated growth restriction in twins is quantitatively similar to that of singletons. This finding is suggestive of dissipation or a ceiling effect to the growth-restricting effect of cigarette smoking.

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