Distinct birth size and postnatal growth patterns in preterm twins and singletons: an etiology-based analysis from the INTERPRACTICE-21st study.
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Roggero Paola, Giuliani Francesca, Gunier Robert B, Winsey Adele, Rauch Stephen A, Izquierdo Renau Montserrat, Coronado Zarco Irma Alejandra, Ariff Shabina, Rego Maria Albertina S, Soto Conti Constanza, Ochieng Roseline, Tuzun Funda, Asibey Jacqueline, Shekharappa Chandrakala Bada, Lapillonne Alexandre, Tavcioska Gabriela, Cheikh Ismail Leila, Menis Camilla, Markelova Marina, Nieto Ricardo, Agyeman-Duah Josephine N A, Deantoni Sonia, Frias Madrid Brenda, Mosca Fabio, Ryumina Irina, Fumagalli Monica, Eskenazi Brenda, Bhutta Zulfiqar, Papageorghiou Aris, Kennedy Stephen, Villar Jose
Аннотация
STUDY DESIGN: Preterm twins and singletons (n = 3245) were classified into nine subgroups based on predefined preterm birth etiologies. Postnatal growth (weight, length and head circumference) trajectories were evaluated using multilevel linear regression models accounting for repeated measurements, expressed as z-score changes from birth to hospital discharge based on INTERGROWTH-21st Standards.
RESULTS: Twins were significantly smaller at birth than singletons, particularly in late preterm category, but not in the very preterm category. Twin postnatal growth was slower (unadjusted models); most differences attenuated or reversed after adjusting for birth size and key covariates. Twins in the 'pre-eclampsia' subgroup showed greater adjusted postnatal weight, whereas weight gain was persistently lower in the 'perinatal sepsis' subgroup.
CONCLUSION: Preterm twins and singletons have distinct intrauterine and postnatal growth patterns, varying by preterm birth etiology and gestational age categories.