Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Dec 3;16(12):e75029.
doi: 10.7759/cureus.75029. eCollection 2024 Dec.

Impact of Chorionicity in Neurodevelopmental Outcomes in Preterm Twins

Catarina Leuzinger Dias  1 , Catarina Cordeiro  1 , Margarida Camacho-Sampaio  1 , Andreia Lomba  1 , Adelaide Taborda  1
Affiliations

Impact of Chorionicity in Neurodevelopmental Outcomes in Preterm Twins

Catarina Leuzinger Dias et al. Cureus. .

Abstract

Introduction Multifetal pregnancies, which account for 2-4% of births worldwide, have increased in recent years. Twin pregnancies carry a higher risk of preterm birth and associated neonatal morbimortality, with monochorionic twins considered at greater risk. This study investigates the influence of chorionicity on neurodevelopmental outcomes in preterm twins. Methods A retrospective cohort study was conducted, including preterm twins born before 32 weeks of gestational age and/or with a birth weight of less than 1500 grams, admitted to a tertiary-hospital neonatal intensive care unit from 2013 to 2021. Neurodevelopmental outcomes were evaluated at 24 months of corrected age using the Griffiths II Mental Development Scales. Moderate to severe neurodevelopmental impairment was determined by the occurrence of one or more of the listed criteria: global development quotient <70, severe visual impairment, cerebral palsy, or profound sensorineural deafness. Results A total of 125 preterm twins were evaluated, of which 45% (n=56) were monochorionic. Overall, 5.6% (n=7) of the infants had moderate to severe neurodevelopmental impairment (NDI), with higher comorbidity rates in this group. No significant differences were found in NDI or other prematurity-related comorbidities between monochorionic and dichorionic twins. Gestational age over 27 weeks and birth weight over 1010 grams were identified as accurate predictors for an absence of moderate to severe NDI in these infants. Conclusion Chorionicity alone does not appear to independently affect neurodevelopmental outcomes in preterm twins when complications are effectively managed. Improved prenatal monitoring and appropriate treatment of twin pregnancies, especially monochorionic, are crucial to mitigate risks associated with moderate to severe neurodevelopmental impairment.

Keywords: chorionicity; neonatology; neurodevelopment; prematurity; twins.

PubMed Disclaimer

Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Ethics Committee of the Unidade Local de Saúde de Coimbra issued approval PI OBS.SF.207-2023. The Commission considers that the ethical requirements associated with conducting the study are deemed to have been met and, therefore, issues a favorable opinion for its development at the ULS of Coimbra . Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Flowchart of patient selection
Figure 2
Figure 2. ROC curve for gestational age (AUC= 0.755, p=0.004; CI 95% 0.58-0.93)
ROC – receiver operating characteristics; AUC – area under the curve
Figure 3
Figure 3. ROC curve for birth weight (AUC = 0.769, p=0.003; 95% CI 0.59-0.95)
ROC – receiver operating characteristics; AUC – area under the curve
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. The perinatal outcome of first and second twin. Radhakrishnan R, Radhakrishnan R. https://www.keralamedicaljournal.com/index.php/KMJ/article/view/558 Kerala Medical Journal. 2019;12
    1. Perinatal outcomes and risk factors for preterm birth in twin pregnancies in a Chinese population: a multi-center retrospective study. Li S, Gao J, Liu J, et al. Front Med (Lausanne) 2021;8:657862. - PMC - PubMed
    1. Trends in morbidity and mortality of extremely preterm multiple gestation newborns. Yeo KT, Lee QY, Quek WS, Wang YA, Bolisetty S, Lui K. Pediatrics. 2015;136:263–271. - PubMed
    1. Twin pregnancy and severe maternal outcomes: the World Health Organization Multicountry Survey on maternal and newborn health. Santana DS, Cecatti JG, Surita FG, et al. Obstet Gynecol. 2016;127:631–641. - PubMed
    1. Neurodevelopmental outcome and adaptive behavior in preterm multiples and singletons at 1 and 2 years of corrected age. Squarza C, Gardon L, Giannì ML, et al. Front Psychol. 2020;11:1653. - PMC - PubMed

LinkOut - more resources