Association between the Degree of Twin Birthweight Discordance and Perinatal Outcomes

Lena H. Kim, Aaron Caughey, Lynn M. Yee, Yvonne W. Cheng

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

BACKGROUND:  Twin birthweight discordance is associated with adverse outcomes. OBJECTIVE:  To determine what degree of twin birthweight discordance is associated with adverse outcomes. STUDY DESIGN:  This is a retrospective cohort study of twins with vertex twin A delivered vaginally at 36 to 40 weeks (U.S. Vital Statistics Natality birth certificate registry data 2012-2014). The primary outcome was a composite of neonatal morbidity: 5-minute Apgar < 7, neonatal intensive care unit admission, neonatal mechanical ventilation > 6 hours, neonatal seizure, and/or neonatal transport to a higher level of care. Effect estimates were expressed as incidence rate and adjusted odds ratio (aOR) controlling for confounding using multivariate clustered analysis for between-pair effects, and multilevel random effect generalized estimating equation regressions to account for within-pair effects. We adjusted for sex discordance, breech delivery of the second twin, maternal race/ethnicity, nulliparity, age, marital status, obesity, and socioeconomic status. RESULTS:  In comparison to birthweight discordance of ≤20%, aORs with 95% confidence intervals (CIs) by weight discordance of the primary outcome among 27,276 twin deliveries were as follows: 20.01 to 25% (aOR: 1.46 [95% CI: 1.29-1.65]); 25.01 to 30% (aOR: 1.96 [95% CI: 1.68-2.29]); and 30.01 to 60% (aOR: 2.97 [95% CI: 2.52-3.50]). CONCLUSION:  Twin birthweight discordance >20% was associated with increased odds of adverse neonatal outcome.

Original languageEnglish (US)
Pages (from-to)969-974
Number of pages6
JournalAmerican journal of perinatology
Volume36
Issue number9
DOIs
StatePublished - Jul 1 2019

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Odds Ratio
Confidence Intervals
Birth Certificates
Vital Statistics
Marital Status
Parity
Social Class
Registries
Seizures
Cohort Studies
Multivariate Analysis
Retrospective Studies
Obesity
Mothers
Morbidity
Weights and Measures
Incidence

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

Association between the Degree of Twin Birthweight Discordance and Perinatal Outcomes. / Kim, Lena H.; Caughey, Aaron; Yee, Lynn M.; Cheng, Yvonne W.

In: American journal of perinatology, Vol. 36, No. 9, 01.07.2019, p. 969-974.

Research output: Contribution to journalArticle

Kim, Lena H. ; Caughey, Aaron ; Yee, Lynn M. ; Cheng, Yvonne W. / Association between the Degree of Twin Birthweight Discordance and Perinatal Outcomes. In: American journal of perinatology. 2019 ; Vol. 36, No. 9. pp. 969-974.
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