Predictive Accuracy of Singleton Versus Customized Twin Growth Chart for Adverse Perinatal Outcome: A Cohort Study

Urszula Nowacka, Katarzyna Kosińska-Kaczyńska, Paweł Krajewski, Aleksandra Saletra-Bielińska, Izabela Walasik and Iwona Szymusik
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Urszula Nowacka: Department of Obstetrics and Gynecology, Medical University of Warsaw, Starynkiewicza Square 1/3, 02-015 Warsaw, Poland
Katarzyna Kosińska-Kaczyńska: Department of Obstetrics and Gynecology, The Center of Postgraduate Medical Education, Cegłowska St. 80, 01-809 Warsaw, Poland
Paweł Krajewski: Department of Obstetrics and Gynecology, Medical University of Warsaw, Starynkiewicza Square 1/3, 02-015 Warsaw, Poland
Aleksandra Saletra-Bielińska: Department of Obstetrics and Gynecology, Medical University of Warsaw, Starynkiewicza Square 1/3, 02-015 Warsaw, Poland
Izabela Walasik: Students Scientific Association, Department of Obstetrics and Gynecology, Medical University of Warsaw, Starynkiewicza Square 1/3, 02-015 Warsaw, Poland
Iwona Szymusik: Department of Obstetrics and Gynecology, Medical University of Warsaw, Starynkiewicza Square 1/3, 02-015 Warsaw, Poland

IJERPH, 2021, vol. 18, issue 4, 1-10

Abstract: Background: Fetal growth of twins differs from singletons. The objective was to assess the fetal growth in twin gestations in relation to singleton charts and customized twin charts, respectively, followed by a comparison of the frequency of neonatal complications in small-for-gestational-age (SGA) twins. Methods: We performed an analysis of twin pregnancies with established chorionicity with particular emphasis on postnatal adverse outcomes in newborns classified as SGA. Neonatal birth weight was comparatively assessed using both singleton and twin growth charts with following percentile estimation. Using a statistical model, we established the prediction strength of neonatal complications in SGA twins for both methods. Results: The dataset included 322 twin pairs (247 cases of dichorionic and 75 cases of monochorionic diamniotic gestations). Utilization of twin-specific normograms was less likely to label twins as SGA—nevertheless, this diagnosis strongly correlated with risk of observing adverse outcomes. Using a chart dedicated for twin pregnancies predicted newborn complications in the SGA group with higher sensitivity and had better positive predictive value regarding postnatal morbidity. Conclusions: Estimating twin growth with customized charts provides better prognosis of undesirable neonatal events in the SGA group comparing to singleton nomograms and consequently might determine neonatal intensive care prenatal approach.

Keywords: twin gestation; growth chart; small for gestational age; fetal growth restriction; fetal growth (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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