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Birth weight discordance in very low birth weight twins: mortality, morbidity, and neurodevelopment

Journal of Perinatology volume 39, pages 1229–1240 (2019)Cite this article

Subjects

Abstract

Objective

Examine outcomes among birth weight concordant and discordant 401–1500 g twins.

Study design

Twins (n = 8,114) at NICHD Neonatal Research Network (1994–2011) were studied. Discordance (birth weight difference/larger twin birth weight x 100%) was categorized into: ≤ 14, > 14–20, > 20–30, and > 30%. Separate logistic regression models for the smaller and larger infants assessed the adjusted association between discordance and outcomes.

Results

Compared with the smaller twin with ≤ 14% discordance, mortality, necrotizing enterocolitis, severe retinopathy of prematurity, bronchopulmonary dysplasia, and neurodevelopmental impairment or death were highest among the smaller twins with discordance > 30%. The larger twins with discordance > 30% had higher odds of patent ductus arteriosus, moderate-to-severe cerebral palsy, blindness, cognitive and motor scores < 70. Odds of cerebral palsy and blindness were also higher among the larger twins with discordance > 14–20%.

Conclusions

Discordance > 30% was associated with higher mortality in the smaller twin and higher morbidities among the smaller and larger twins.

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Acknowledgements

See Supplement B.

Funding:

Supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).

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Authors and Affiliations

  1. Department of Epidemiology & Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA

    Nansi S. Boghossian

  2. Social, Statistical and Environmental Sciences Unit, RTI International, Research Triangle Park, NC, USA

    Shampa Saha

  3. Department of Pediatrics, University of Iowa, Iowa City, IA, USA

    Edward F. Bell

  4. Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA

    Jane E. Brumbaugh

  5. Department of Pediatrics, Wayne State University, Detroit, MI, USA

    Seetha Shankaran

  6. Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA

    Waldemar A. Carlo

  7. Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville, MD, USA

    Abhik Das

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  1. Nansi S. Boghossian
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for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network

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Correspondence to Edward F. Bell.

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Boghossian, N.S., Saha, S., Bell, E.F. et al. Birth weight discordance in very low birth weight twins: mortality, morbidity, and neurodevelopment. J Perinatol 39, 1229–1240 (2019). https://doi.org/10.1038/s41372-019-0427-5

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