Birth weight discordance in very low birth weight twins
Mortality, morbidity, and neurodevelopment
Boghossian, N. S., Saha, S., Bell, E. F., Brumbaugh, J. E., Shankaran, S., Carlo, W. A., Das, A., & Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network (2019). Birth weight discordance in very low birth weight twins: Mortality, morbidity, and neurodevelopment. Journal of Perinatology, 39(9), 1229-1240. Advance online publication. https://doi.org/10.1038/s41372-019-0427-5
OBJECTIVE: Examine outcomes among birth weight concordant and discordant 401-1500 g twins.
STUDY DESIGN: Twins (n = 8,114) at NICHD Neonatal Research Network (1994-2011) were studied. Discordance (birth weight difference/larger twin birth weight x 100%) was categorized into: ≤ 14, > 14-20, > 20-30, and > 30%. Separate logistic regression models for the smaller and larger infants assessed the adjusted association between discordance and outcomes.
RESULTS: Compared with the smaller twin with ≤ 14% discordance, mortality, necrotizing enterocolitis, severe retinopathy of prematurity, bronchopulmonary dysplasia, and neurodevelopmental impairment or death were highest among the smaller twins with discordance > 30%. The larger twins with discordance > 30% had higher odds of patent ductus arteriosus, moderate-to-severe cerebral palsy, blindness, cognitive and motor scores < 70. Odds of cerebral palsy and blindness were also higher among the larger twins with discordance > 14-20%.
CONCLUSIONS: Discordance > 30% was associated with higher mortality in the smaller twin and higher morbidities among the smaller and larger twins.
