Is birth weight discordance in twin births a risk factor for neonatal morbidity and mortality?

Abstract

Files of 164 twin pairs followed in Ondokuz Mayis University Neonatal Intensive Care Unit (NICU) were retrospectively evaluated to determine if discordance has a prognostic value in twin pregnancies' outcome. Discordance was defined as birth weight difference of ?15%. In the discordant group, high-risk pregnancy, cesarean delivery, same sex and small for gestational age (SGA) were more frequent, and the mean parity and maternal age were higher. Mortality rate was similar between small and large pairs of discordant twins. Sepsis and polycythemia were more frequent in discordant and appropriate for gestational age twins. Hypoglycemia, anemia and respiratory distress syndrome (RDS) were observed more frequently with decreasing gestational age. When SGA frequency increased, RDS decreased and when gestational age decreased, sepsis increased. We suggest that discordant growth does not increase the risk for morbidity and mortality in twins in modern NICUs. Birth weight, gestational age and growth retardation must be evaluated together with discordance to predict neonatal morbidity and mortality.