Abstract
To investigate childhood growth patterns in twins and to determine whether they show the same signs of excess growth as singletons born small-for-gestational age (SGA), which may confer future cardiometabolic risk. In the Upstate KIDS cohort of infants delivered from 2008 through 2010, we compared height, weight, and body mass index (BMI) z-scores at 0-3 and 7-9years of age, as well as risk of rapid weight gain (RWG) in infancy and overweight/obesity beginning at 2years, among appropriate-for-gestational age (AGA) twins (n=1121), AGA singletons (n=2684), and two groups of SGA twins: uncertain SGA twins (<10th percentile for birthweight by a singleton reference but >10th% by a population-based twin birthweight reference; n=319) and true SGA twins (<10th% by a population-based twin reference; n=144). Compared with AGA twins, both SGA twin groups had lower weight and BMI z-scores at both time points. By 7-9years, both groups caught up in height with AGA twins. Compared with AGA singletons, z-score differences decreased between 0-3 and 7-9years for uncertain SGA and true SGA twins, though true SGA twins had the lowest z-scores for all measures. During infancy, twins were more likely to display RWG compared with AGA singletons (RR=2.06 to 2.67), which may reflect normal catch-up growth, as no twin group had higher prevalence of overweight/obesity at either time point. Though twins had lower height, weight, and BMI z-scores at birth and into toddlerhood, differences were reduced by 7-9years, with no evidence of pathological growth and no group of twins showing elevated risk of overweight/obesity.
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