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Twin-Specific Intrauterine ‘Growth’ Charts Based on Cross-Sectional Birthweight Data

Published online by Cambridge University Press:  21 February 2012

Marij Gielen*
Affiliation:
Nutrition and Toxicology Research Institute Maastricht (NUTRIM), Department of Genetics and Cell Biology, Maastricht University, Maastricht, the Netherlands; Unit of Genetic Epidemiology, Department of Public Health and Epidemiology, University of Birmingham, Birmingham, United Kingdom. marij.gielen@gen.unimaas.nl
Patrick J. Lindsey
Affiliation:
Unit of Genetic Epidemiology, Department of Public Health and Epidemiology, University of Birmingham, Birmingham, United Kingdom.
Catherine Derom
Affiliation:
Department for Human Genetics, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium.
Ruth J. F. Loos
Affiliation:
MRC Epidemiology Unit, Cambridge, United Kingdom; Department of Sport and Movement Science, Faculty of Kinesiology and Rehabilitation Sciences, Catholic University of Leuven, Leuven, Belgium.
Nicole Y. Souren
Affiliation:
Nutrition and Toxicology Research Institute Maastricht (NUTRIM), Department of Genetics and Cell Biology, Maastricht University, Maastricht, the Netherlands; Unit of Genetic Epidemiology, Department of Public Health and Epidemiology, University of Birmingham, Birmingham, United Kingdom.
Aimee D. C. Paulussen
Affiliation:
Department of Clinical Genetics, University Hospital Maastricht, Maastricht, the Netherlands.
Maurice P. Zeegers
Affiliation:
Nutrition and Toxicology Research Institute Maastricht (NUTRIM), Department of Genetics and Cell Biology, Maastricht University, Maastricht, the Netherlands; Unit of Genetic Epidemiology, Department of Public Health and Epidemiology, University of Birmingham, Birmingham, United Kingdom.
Robert Derom
Affiliation:
Association for Scientific Research in Multiple Births, Destelbergen, Belgium.
Robert Vlietinck
Affiliation:
Department for Human Genetics, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium.
Jan G. Nijhuis
Affiliation:
Department of Obstetrics and Gynaecology, University Hospital Maastricht, Maastricht, the Netherlands.
*
1Author for correspondence: Marij Gielen, Department of Genetics and Cell Biology, Maastricht University, Universiteitssingel 50 Box 616, 6200 MD Maastricht, the Netherlands.

Abstract

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The assessment of fetal growth is an essential component of good antenatal care, especially for twins. The aims of this study are to develop twin-specific intrauterine 'growth' charts, based on cross-sectional birthweight data, for monochorionic and dichorionic twins according to sex and parity, and to detect twins at risk for neonatal death by comparing the use of twin-specific and singleton charts. The study sample consisted of 76,471 singletons and 8454 twins (4227 pairs) born in East Flanders (Belgium). Birthweights were analyzed using a nonlinear Gaussian regression. After 33 weeks of gestation, the birthweights of twins started to deviate from singletons (difference of 900 grams at 42 weeks). Birthweights of dichorionic twins continued to increase, whereas those of monochorionic twins decreased after week 40 (difference of more than 300 g at 42 weeks). After 31 weeks of gestation, neonatal mortality increased as centile decreased, and was especially high if birthweight was below the twin-specific third centile: .032 (below) versus .007 (above). Using singleton centiles, this was less obvious. In conclusion, twin-specific growth charts, taking chorionicity into account, are more accurate to detect twins at risk for neonatal death. Therefore the presented charts, based on cross-sectional birthweight data, enable an improved assessment of twin growth.

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Copyright © Cambridge University Press 2008
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