Selective and non-selective intrauterine growth restriction in twin pregnancies: high-risk factors and perinatal outcome.

PURPOSE: To evaluate the high-risk factors and perinatal outcome in selective intrauterine growth restriction (sIUGR) and non-selective IUGR (non-sIUGR) in twins.

METHODS

In total, 336 pairs of twins were enrolled from December 2003 to 2009. According to the birth weight, 295 pairs of twins were divided into sIUGR, non-sIUGR and normal growth groups. Maternal characteristics, complications, chorionicity, zygosity and perinatal outcomes were analyzed among the three groups.

RESULTS

The overall IUGR incidence (including sIUGR and non-sIUGR) in twin pregnancies was 23.2%. The sIUGR incidence was ten times greater than that of non-sIUGR. Monochorionicity and monozygosity were risk factors for overall IUGR, especially for the sIUGR (P < 0.01). Pre-eclampsia was more common in sIUGR than in the normal growth group (P < 0.05). Both the sIUGR and non-sIUGR groups had more intrauterine fetal death and neonatal death than the normal growth group (P < 0.01). The sIUGR group had more brain injury than the normal growth group (P < 0.01).

CONCLUSION

Monochorionicity, monozygosity, pre-eclampsia were high-risk factors for IUGR in twins. Perinatal death was more prevalent in the non-sIUGR group, and neonatal brain damage was more prevalent in the sIUGR group.