Background

In addition to prematurity and low birth weight (LBW), twin pregnancies are also complicated with discordant growth; which has been reported to be associated with increased neonatal morbidity and mortality

The lack of a standard definition for a clinically significant growth difference within a twin pair is partly a result of conflicting data on the associated adverse perinatal outcomes.

Objectives

Assess the difference in neonatal outcomes across discordant twins admitted to the NICU

Methods

A retrospective study of preterm twins, followed in NICU of Hospital of Obstetric and Gynecology, Varna, from 01. January 2015 to 31. Decembre 2018. Twins were classified as discordant when the difference in birth weight was >15%. Discordance was determined by the formula:

(birth weight of larger twin - birth weight of smaller twin)/birth weight of larger twin x 100.

Short-term outcome include asphyxia, RDS, infection, severe IVH, congenital anomalies, mortality. Other data points analyzed included birth weight, gestational age, gender, mode of delivery.

Results

Birthweight discordance is an indicator of complications that affect intrauterine growth in one of the twins, and usually cause the birth of a SGA infant. No significant difference for RDS, surfactant therapy, MV. The smaller twin show more often low Apgar score, congenital anomalies , intraventricular hemorrhage higher risk of mortality.

Conclusion

Conclusion: Incidence and outcome of discordant twins were assessed based on birth weight difference more than 20 %, releated with VLBW and VLGA. Discordant growth is a risk factor for prolonged hospitalization. The mortality rate did not differ between concordant and discordant groups.