The relation between inter-twin birth weight discordance and total twin birth weight

Abstract

The more favorable the uterine milieu for carrying twins, the smaller the likelihood of discordant twin growth. Birth order of the heavier twin appears to be an integral part of the discordance phenomenon. The similarity of the cohorts suggests that these conclusions are valid for both like and unlike-sexed twins.

Intrapair birthweight discordance in twins

“…As a consequence, multiparous women were more likely to deliver larger twins with higher combined twin birthweight. This is in keeping with the report of Blickstein et al, [3,15] which showed that the higher the combined twin birthweight the less likely it was to deliver discordant pairs. In that report, they stated that the uteri that can efficiently nurture twins are associated with increased combined twin birthweight and decreased discordant frequencies.…”

“…It has been shown that the lower the combined twin birthweight, the higher the frequency of delivery of birthweight-discordant twins. [3,12] On the other hand, when 25% cut-off point was applied, our frequency (9.6%) compared favorably with 9.3% reported by Ekure and Iroha [16] in Lagos, Nigeria. Further comparison was not possible because the authors of the Lagos study did not state the prevalence using 15% as a cut-off point.…”

“…[17] Although same-sex twin pairs accounted for 60% of all cases of birthweight discordance, the difference was not statistically significant. Other investigators [3,18] have reported similar higher frequency of discordance in same-sex twin pairs, suggesting that birthweight in females may be influenced by a male co-twin, resulting in decreased frequency of intrapair birthweight discordance in different-sexed twin pairs. In this regard, Rydhstroem [19] reported that fetal loss was two times higher in the same-sex compared to different-sex twin pairs and only in the same-sexed pairs was fetal loss significantly correlated with birthweight discordance.…”

“…[1] The threshold for clinically significant discordance has been variably defined as 15% [1,2] and 25%, [3] respectively. Using a birthweight difference of more than 25% as a cutoff point, Blickstein et al, compared two cohorts of twin pairs, one from four different perinatal centers (United States, Poland, and two from Israel) and the other from a Swedish population-based data; they found birthweight discordance of 11% in the former and 12% in the latter.…”

“…Using a birthweight difference of more than 25% as a cutoff point, Blickstein et al, compared two cohorts of twin pairs, one from four different perinatal centers (United States, Poland, and two from Israel) and the other from a Swedish population-based data; they found birthweight discordance of 11% in the former and 12% in the latter. [3] Some investigators have reported that divergent fetal growth increases the risk of fetal death [2,4,5] and other adverse outcomes such as prematurity [4,6] with its attendant morbidity and mortality. In a study of 122 live-born twin pairs delivered between 25-and 34-week gestation, Cheung et al [7] reported that birthweight discordance greater than 30% was associated with congenital anomalies and complications of prematurity.…”