Abstract

Aim: To determine whether birth weight discordance is a risk factor for preterm birth of twins and further evaluation of the relationships involved.

Methods: This prospective study was carried out in Al-Batool-Maternity Teaching Hospital in Mosul-IRAQ from the 1 of May 2006 to the 30 of April 2007. The study comprised 200 pregnant women with live-born twins delivered at >24 completed weeks of gestation, and all were analyzed for gestational age at delivery, birth weight discordance rate, and it is the percentage. The risk of preterm birth was estimated, and comparison was made between the concordant and discordant groups regarding maternal variables and neonatal outcomes.

Results: The degree of discordance correlated strongly with the risk of live preterm birth, especially for discordance > 30% and gestational age < 32 weeks. Among 200 twin pregnancies with discordance 15-19%, 5% of emended in birth< 32 weeks gestation versus 40% of discordance, 470 ended in birth at <32 weeks, while 25% of those with Cordance 25-29%, were ended in birth at < 32 weeks, and 30% of OS discordance of> 30% was delivered at < 32 weeks of gestation, respectively y, and only 11.1% of later ended in the birth of > 37 weeks of gestation. There was a statistically significant association weight between twin birth weight discordance and preterm birth and was further strengthened by (final odd Ratio; P < 0.001) in a multivariate model containing other risk factors including maternal age, parity, education, smoking, either twin small for gestation age (SGA), chorionicity, and liked fetal sex. Also, the discordant twins had a high rate of the low Apgar score (<7) at one and five minutes for both pair of twin, also a high rate of admission to NICU, and a high rate of early neonatal death, as about 18.4%, 25.3% of first and second twins ended with early neonatal death, respectively.

Conclusions: Twin birth weight discordance has now clearly been demonstrated to be a risk factor for preterm birth, and discordance places Twins at increased risk for adverse neonatal outcomes.

Keywords: birth weight, discordance, preterm birth, twins