COMPARATIVE ANALYSIS OF THE NEONATE BIRTH WEIGHT IN DIFFERENT TYPES OF TIN PREGNANCY
Article PDF (Українська)

Keywords

birth weight discordance, fetal growth restriction, gestational age, small for gestational age newborn, twins

Abstract views: 26
PDF Downloads: 18

How to Cite

Tepla, I. (2021). COMPARATIVE ANALYSIS OF THE NEONATE BIRTH WEIGHT IN DIFFERENT TYPES OF TIN PREGNANCY. Medical Science of Ukraine (MSU), 17(1), 35-46. https://doi.org/10.32345/2664-4738.1.2021.05

Abstract

The relevance of the study lies in the significant increase in multiple pregnancies connected with the higher risk of perinatal complications, the controversy over the effects of chorionicity and sex of the babies on their birth weight, the need for timely diagnosis of fetal growth restriction, and associated morbidity.

The objective of this study was to compare fetal weights at the birth of different variants of twins depending on chorionicity, gestational age, and sex.

Materials and methods. During 2016-2020, 440 pairs of twins were examined: 375 dichorionic diamniotic and 65 monochorionic diamniotic (38 – boys, 27 – girls). Among dichorionic couples there were 186 (49.6%) opposite-sex, 98 (26.1%) same-sex males and 91 (24.3%) same-sex females. Fetal weight was measured at birth, and its relationship to chorionicity, fetal sex, a combination of same-sex or opposite-sex co-twins, and gestational age was assessed.

Results. The average weight of 750 fetuses from dichorionic pairs (2570.0 ± 506.43 g) significantly exceeded the weight of 130 fetuses from monochorionic pairs (2333.4 ± 567.24 g, p < 0.0001). The same-sex male (2603.8 ± 532.29 g) and opposite-sex dichorionic diamniotic (2595.6 ± 490.17 g). twins’ masses significantly surpassed the mass of all other twins (p <0.05). In the group of dichorionic twins, the weight of boys exceeded the weight of girls (2638.1 ± 525.96 g vs. 2499.4 ± 475.84 g, p = 0.0002). This pattern was observed both inside the opposite-sex pairs (2674.2 ± 518.17 g vs. 2517.1 ± 448.24 g, p = 0.0019), and same-sex couples of boys compared to same-sex couples of girls (2603.8 ± 532.29 g and 2481.4 ± 503.08 g, respectively, p = 0.0224). No significant difference in the weight of girls of opposite-sex twins compared to same-sex couples was seen. In monochorionic pairs, the weight of male and female fetuses did not differ significantly. Birth weight discordance was found in all types of twins, the highest percentage of discordance was registered in monochorionic boys – 23.7%, second place in frequency took male dichorionic twins – 20.4%. Among the 30 discordant dichorionic opposite-sex twins in 19 (63.3%) cases, the male fetus was heavier. There was no significant difference in fetal weight when women were fertilized naturally and using assisted reproductive technologies. The average weight of children born by surrogate mothers exceeded the weight of children born by non-surrogate mothers (p = 0.0466). In the first pregnancy, children were born with a lower body weight compared to children born as a result of repeated pregnancies and in women who had a history of childbirth.

Conclusion. The average weight of the fetuses of dichorionic twins was higher than the weight of the neonates f monochorionic pairs. The prevalence of the weight of boys over the weight of girls from dichorionic pairs and the absence of sex difference in fetal weight in monochorionic twins indicates the possibility of different functional activity of the placenta in fetuses of different sexes. Small for gestational age newborns were most often found in the group of female monochorionic twins and opposite-sex dichorionic pairs. Discordance of fetal mass was most common in monochorionic same-sex male twins. In discordant opposite-sex couples, the male fetus more often was heavier. There was no significant difference in newborn weight when women were fertilized naturally and with the use of assisted reproductive technologies. The average weight of surrogate-born children exceeded the weight of children born by non-surrogate mothers. In the first pregnancy, children were born with a lower body weight compared to children of multiparous and multigravida women.

https://doi.org/10.32345/2664-4738.1.2021.05
Article PDF (Українська)

References

Grandi C, Veiga A, Mazzitelli N, Cavalli R de C, Cardoso V. Medidas de crescimento placentário em relação ao peso de nascimento em uma população Latino-Americana. Rev Bras Ginecol e Obstet. 2016 Aug 1;38(8):373-80. DOI:10.1055/s-0036-1586721

View at: Publisher Site: https://www.thieme-connect.de/products/ejournals/abstract/10.1055/s-0036-1586721

PubMed: https://pubmed.ncbi.nlm.nih.gov/27501191/

Jelenkovic A, Sund R, Yokoyama Y, Hur YM, Ullemar V, Almqvist C, et al. Birth size and gestational age in opposite-sex twins as compared to same-sex twins: An individual-based pooled analysis of 21 cohorts. Sci Rep. 2018 Dec 1;8(1): 6300. DOI:10.1038/s41598-018-24634-2

View at: Publisher Site: https://www.nature.com/articles/s41598-018-24634-2

PubMed: https://pubmed.ncbi.nlm.nih.gov/29674730/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5908858/

Risnes KR, Romundstad PR, Nilsen TIL, Eskild A, Vatten LJ. Placental weight relative to birth weight and long-term cardiovascular mortality: Findings from a cohort of 31,307 men and women. Am J Epidemiol. 2009 Sep;170(5):622-31. DOI:10.1093/aje/kwp182

View at: Publisher Site: https://academic.oup.com/aje/article/170/5/622/103205

PubMed: https://pubmed.ncbi.nlm.nih.gov/19638481/

Osianlis T, Rombauts L, Gabbe M, Motteram C, Vollenhoven B. Incidence and zygosity of twin births following transfers using a single fresh or frozen embryo. Hum Reprod. 2014 ;29(7):1438-43. DOI:10.1093/humrep/deu064

View at: Publisher Site: https://academic.oup.com/humrep/article/29/7/1438/902705

PubMed: https://pubmed.ncbi.nlm.nih.gov/24760778/

Vdovychenko Yu.P., & Tkachenko A.V. [Clinical and statistical features of multiple pregnancies at the present stage]. Bulletin of Scientific Researchers. 2005;2:10-13. [in Ukrainian].

EUROPEAN PERINATAL HEALTH REPORT. Core indicators of the health and care of pregnant women and babies in Europe in 2015. 2015;

View at: Publisher Site: https://www.europeristat.com/images/EPHR2015_Euro-Peristat.pdf

Hanson MA, Gluckman PD. Developmental origins of health and disease: New insights. Basic Clin Pharmacol Toxicol; 2008 Feb;102(2):90-3. DOI:10.1111/j.1742-7843.2007.00186.x

View at: Publisher Site: https://onlinelibrary.wiley.com/doi/full/10.1111/j.1742-7843.2007.00186.x

PubMed: https://pubmed.ncbi.nlm.nih.gov/18226060/

Al-Riyami N, Al-Rusheidi A, Al-Khabori M. Perinatal outcome of monochorionic in comparison to dichorionic twin pregnancies. Oman Med J. 2013 May;28(3):173-7. DOI:10.5001/omj.2013.49

View at: Publisher Site: http://www.omjournal.org/articleDetails.aspx?coType=1&aId=374

PubMed: https://pubmed.ncbi.nlm.nih.gov/23772282/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3679607/

Lewi L. Monochorionic diamniotic twin pregnancies pregnancy outcome, risk stratification and lessons learnt from placental examination. Verh K Acad Geneeskd Belg. 2010;72(1-2):5-15.

View at: PubMed: https://pubmed.ncbi.nlm.nih.gov/20726437/

Europe PMC: https://europepmc.org/article/med/20726437

Beune IM, Pels A, Gordijn SJ, Ganzevoort W. Temporal variation in definition of fetal growth restriction in the literature. Ultrasound Obstet Gynecol. 2019 May; 53(5): 569-70. DOI:10.1002/uog.19189

View at: Publisher Site: https://obgyn.onlinelibrary.wiley.com/doi/full/10.1002/uog.19189

PubMed: https://pubmed.ncbi.nlm.nih.gov/30079567/

Monier I, Ancel PY, Ego A, Jarreau PH, Lebeaux C, Kaminski M, Goffinet F, Zeitlin J, EPIPAGE 2 Study Group. Fetal and neonatal outcomes of preterm infants born before 32 weeks of gestation according to antenatal vs postnatal assessments of restricted growth. Am J Obstet Gynecol. 2017 May 1;216(5):516.e1-516.e10. DOI:10.1016/j.ajog.2017.02.001

View at: Publisher Site: https://www.ajog.org/article/S0002-9378(17)30178-3/fulltext

PubMed: https://pubmed.ncbi.nlm.nih.gov/28188770/

Salavati N, Smies M, Ganzevoort W, Charles AK, Erwich JJ, Plösch T, Gordijn SJ. The possible role of placental morphometry in the detection of fetal growth restriction. Frontiers in Physiology. 2019 Jan 8;9:1884. DOI:10.3389/fphys.2018.01884

View at: Publisher Site: https://www.frontiersin.org/articles/10.3389/fphys.2018.01884/full

PubMed: https://pubmed.ncbi.nlm.nih.gov/30670983/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6331677/

Stirnemann J, Villar J, Salomon LJ, Ohuma E, Ruyan P, Altman DG, et al. International estimated fetal weight standards of the INTERGROWTH-21st Project. Ultrasound Obstet Gynecol. 2017 Apr 1;49(4):478-86. DOI:10.1002/uog.17347

View at: Publisher Site: https://obgyn.onlinelibrary.wiley.com/doi/full/10.1002/uog.17347

PubMed: https://pubmed.ncbi.nlm.nih.gov/27804212/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5516164/

Papageorghiou AT, Kennedy SH, Salomon LJ, Altman DG, Ohuma EO, Stones W, et al. The INTERGROWTH-21st fetal growth standards: toward the global integration of pregnancy and pediatric care. American Journal of Obstetrics and Gynecology. 2018 Feb;218(2S):S630-S640. doi:10.1016/j.ajog.2018.01.011

View at: Publisher Site: https://www.ajog.org/article/S0002-9378(18)30012-7/fulltext

PubMed: https://pubmed.ncbi.nlm.nih.gov/29422205/

Breathnach FM, McAuliffe FM, Geary M, Daly S, Higgins JR, Dornan J, Morrison JJ, Burke G, Higgins S, Dicker P, Manning F, Mahony R, Malone FD, Perinatal Ireland Research Consortium. Definition of intertwin birth weight discordance. Obstet Gynecol. 2011 Jul;118(1):94-103. DOI:10.1097/AOG.0b013e31821fd208

View at: Publisher Site: https://journals.lww.com/greenjournal/Fulltext/2011/07000/Definition_of_Intertwin_Birth_Weight_Discordance.14.aspx

PubMed: https://pubmed.ncbi.nlm.nih.gov/21691168/

Hu IJ, Hsieh CJ, Jeng SF, Wu HC, Chen CY, Chou HC, Tsao PN, Lin SJ, Chen P-C, Hsieh W-S. Nationwide Twin Birth Weight Percentiles by Gestational Age in Taiwan. Pediatr Neonatol. 2015 Oct 1; 56(5):294-300. DOI:10.1016/j.pedneo.2014.12.004

View at: Publisher Site: https://www.pediatr-neonatol.com/article/S1875-9572(15)00020-0/fulltext

PubMed: https://pubmed.ncbi.nlm.nih.gov/25797652/

Arbuckle TE, Wilkins R, Sherman GJ. Birth weight percentiles by gestational age in Canada. Obstet Gynecol. 1993 Jan; 81(1): 39-48.

View at: PubMed: https://pubmed.ncbi.nlm.nih.gov/8416459/

Dai L, Deng C, Li Y, Yi L, Li X, Mu Y, Li Q, Yao Q, Wang Y. Population-based birth weight reference percentiles for Chinese twins. Ann Med. 2017 Aug 18;49(6):470-8. DOI:10.1080/07853890.2017.1294258

View at: Publisher Site: https://www.tandfonline.com/doi/full/10.1080/07853890.2017.1294258

PubMed: https://pubmed.ncbi.nlm.nih.gov/28276868/

Skjærven R, Gjessing’ HK, Bakketeig LS. Birthweight by gestational age in Norway. Acta Obstet Gynecol Scand. 2000;79(6):440-9. DOI:10.1034/j.1600-0412.2000.079006440.x

View at: Publisher Site: https://obgyn.onlinelibrary.wiley.com/doi/10.1034/j.1600-0412.2000.079006440.x

Europe PMC: https://europepmc.org/article/med/10857867

Zhang B, Cao Z, Zhang Y, Yao C, Xiong C, Zhang Y, Wang Y, Zhou A. Birthweight percentiles for twin birth neonates by gestational age in China. Sci Rep. 2016 Aug 10; 6:31290. DOI:10.1038/srep31290

View at: Publisher Site: https://www.nature.com/articles/srep31290

PubMed: https://pubmed.ncbi.nlm.nih.gov/27506479/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4978964/

Li Z, Umstad MP, Hilder L, Xu F, Sullivan EA. Australian national birthweight percentiles by sex and gestational age for twins, 2001-2010. BMC Pediatr. 2015 Oct 8;15(1): 148. DOI:10.1186/s12887-015-0464-y

View at: Publisher Site: https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-015-0464-y

PubMed: https://pubmed.ncbi.nlm.nih.gov/26450410/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4599725/

Luke B, Hediger M, Min SJ, Brown MB, Misiunas RB, Gonzalez-Quintero VH, et al. Gender mix in twins and fetal growth, length of gestation and adult cancer risk. Paediatr Perinat Epidemiol. 2005 Jan;19 Suppl 1:41-7. DOI:10.1111/j.1365-3016.2005.00616.x

View at: Publisher Site: https://onlinelibrary.wiley.com/doi/full/10.1111/j.1365-3016.2005.00616.x

PubMed: https://pubmed.ncbi.nlm.nih.gov/15670121/

Freedman AA, Hogue CJ, Marsit CJ, Rajakumar A, Smith AK, Grantz KL, Goldenberg RL, Dudley DJ, Saade GR, Silver RM, Gibbins KJ, Bukowski R, Drews-Botsch C. Associations between features of placental morphology and birth weight in dichorionic twins. Am J Epidemiol. 2019 Mar 1;188(3):518-26. DOI:10.1093/aje/kwy255

View at: Publisher Site: https://academic.oup.com/aje/article/188/3/518/5193217

PubMed: https://pubmed.ncbi.nlm.nih.gov/30452541/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6395169/

Zhao D, Lipa M, Wielgos M, Cohen D, Middeldorp JM, Oepkes D, Lopriore E. Comparison between Monochorionic and Dichorionic Placentas with Special Attention to Vascular Anastomoses and Placental Share. Twin Res Hum Genet. 2016 Jun 1; 19(3):191-6. DOI:10.1017/thg.2016.19

View at: Publisher Site: https://www.cambridge.org/core/journals/twin-research-and-human-genetics/article/comparison-between-monochorionic-and-dichorionic-placentas-with-special-attention-to-vascular-anastomoses-and-placental-share/36382444D741E8F7CDAEE027B6831C59

PubMed: https://pubmed.ncbi.nlm.nih.gov/27068823/

Waszak M., Cieślik K., Kempiak J., Bręborowicz G., Gadzinowski J. Relationship between type and weight of placenta and neonate birth weight in twin pregnancy. Anthropological Review. 2013; 76(2), 173-82. DOI: 10.2478/anre-2013-0017

View at: Publisher Site: https://sciendo.com/article/10.2478/anre-2013-0017

Kiserud T, Piaggio G, Carroli G, Widmer M, Carvalho J, Neerup Jensen L, et al. The World Health Organization Fetal Growth Charts: A Multinational Longitudinal Study of Ultrasound Biometric Measurements and Estimated Fetal Weight. PLoS Med. 2017 Jan 24; 14(1):e1002220. DOI:10.1371/journal.pmed.1002220

View at: Publisher Site: https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002220

PubMed: https://pubmed.ncbi.nlm.nih.gov/28118360/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5261648/

Voicu N-L, Berceanu S, Paitici Ş, RoŞu G-C, Iovan L, Berceanu C, BohÎlŢea RE, Istrate-OfiŢeru A-M. Clinical and Morphological Study of Single and Twin Pregnancies Placenta. Curr Heal Sci J. 2020 Jan-Mar; 46(1):44-55. DOI:10.12865/CHSJ.46.01.07

View at: Publisher Site: https://www.chsjournal.org/article/46/1/7/

PubMed: https://pubmed.ncbi.nlm.nih.gov/32637165/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7323729/

Sankilampi U, Hannila ML, Saari A, Gissler M, Dunkel L. New population-based references for birth weight, length, and head circumference in singletons and twins from 23 to 43 gestation weeks. Ann Med. 2013 Sep; 45(5-6):446-54. DOI:10.3109/07853890.2013.803739

View at: Publisher Site: https://www.tandfonline.com/doi/full/10.3109/07853890.2013.803739

PubMed: https://pubmed.ncbi.nlm.nih.gov/23768051/

Melamed N, Yogev Y, Glezerman M. Effect of fetal sex on pregnancy outcome in twin pregnancies. Obstet Gynecol. 2009 Nov;114(5):1085-92. DOI:10.1097/AOG.0b013e3181bd8874

View at: Publisher Site: https://journals.lww.com/greenjournal/Fulltext/2009/11000/Effect_of_Fetal_Sex_on_Pregnancy_Outcome_in_Twin.19.aspx

PubMed: https://pubmed.ncbi.nlm.nih.gov/20168111/

Lampl M, Gotsch F, Kusanovic JP, Gomez R, Nien JK, Frongillo EA, Romero R. Sex Differences in Fetal Growth Responses to Maternal Height and Weight. Am J Hum Biol. 2010 Jul;22(4):431-43. DOI:10.1002/ajhb.21014

View at: Publisher Site: https://onlinelibrary.wiley.com/doi/abs/10.1002/ajhb.21014

PubMed: https://pubmed.ncbi.nlm.nih.gov/19950190/

PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3437780/

Figueras F, Gratacos E. An integrated approach to fetal growth restriction. Best Practice and Research: Clinical Obstetrics and Gynaecology. 2017 Jan;38:48-58. DOI:10.1016/j.bpobgyn.2016.10.006

View at: Scopus: https://www.sciencedirect.com/science/article/abs/pii/S1521693416301109?via%3Dihub

PubMed: https://pubmed.ncbi.nlm.nih.gov/27940123/

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.