January 17th, 2021

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Neonatal Outcome of Selective and Nonselective Small-for-Gestational-Age Twins: A Case Control Study
Authors:  Katarzyna Kosinska-Kaczynska, M.D., Ph.D., Wojciech Ananicz, M.D., Justyna Maret, M.D., Katarzyna Szarla, M.D., and Iwona Szymusik, M.D., Ph.D.
  OBJECTIVE: To investigate if neonatal outcome of small-for-gestational-age (SGA) twins depends on chorionicity and on the co-twin being appropriate or small for gestational as well.

STUDY DESIGN: A case-control study of 125 selective SGA and 60 nonselective SGA twins was conducted.

RESULTS: Selective SGA twins were born significantly earlier and with lower birthweight than nonselective SGA twins. There were no differences in neonatal complications between selective and nonselective SGA twins. Selective SGA monochorionic twins were admitted to intensive care unit more often than were dichorionic ones (RR 6.57, 95% CI 3.9–10.14). Monochorionic nonselective SGA twins required mechanical ventilation and intensive care unit admission more frequently than did dichorionic ones (RR 8.72, 95% CI 3.1–32.8 and RR 4.58, 95% CI 0.97–31.2, respectively). In logistic regression analysis only gestational age at delivery, birthweight, and chorionicity influenced the neonatal outcome significantly (aOR 4.33 [95% CI 1.28–7.12], 6.25 [95% CI 4.98–8.72], and 3.18 [95% CI 1.54–4.11], respectively).

CONCLUSION: Neonatal outcome of SGA twins depends on gestational age at delivery, birthweight, and chorionicity but not on the co-twin being SGA as well.
Keywords:  fetal growth, multiple pregnancy, neonatal outcome, small for gestational age, twin growth discordance, twin pregnancy, twins
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