ABSTRACT
We sought to estimate the association of several maternal risk factors with intrauterine
growth restriction (IUGR) in twin pregnancies. This is a case-control study of 313
patients with twin pregnancies delivered greater than 24 weeks between June 2005 and
January 2010. We used three definitions of IUGR: (1) either twin with a birth weight
< 10th percentile for gestational age; (2) either twin with a birth weight < 5th percentile
for gestational age; and (3) birth-weight discordance ≥ 20%. Using each definition
of IUGR, we estimated the association between IUGR and maternal age, weight, monochorionicity,
in vitro fertilization, pregnancy reduction, thrombophilia, hypertension, and diabetes.
Overall, 47% of patients delivered at least one twin with a birth weight <10th percentile,
27% of patients delivered at least one twin with a birth weight <5th percentile, and
16% of patients had birth-weight discordance of ≥20%. Using any of these three definitions
for IUGR in twin pregnancies, there was no significant association between IUGR and
any of the risk factors examined. This remained true when we excluded all patients
who delivered <34 weeks. IUGR is very common in twin pregnancies. However, in twin
pregnancies, IUGR cannot be predicted by maternal risk factors.
KEYWORDS
Twins - IUGR - incidence - prediction
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Nathan S FoxM.D.
Maternal Fetal Medicine Associates, PLLC
70 East 90th Street, New York, NY 10128
Email: nfox@mfmnyc.com