Causes of Delivery and Outcomes of Very Preterm Twins Stratified to Zygosity

2012 | journal article. A publication with affiliation to the University of Göttingen.

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​Causes of Delivery and Outcomes of Very Preterm Twins Stratified to Zygosity​
Spiegler, J.; Haertel, C.; Schulz, L.; von Wurmb-Schwark, N.; Hoehn, T.; Kribs, A. & Kuester, H. et al.​ (2012) 
Twin Research and Human Genetics15(4) pp. 532​-536​.​ DOI: https://doi.org/10.1017/thg.2012.33 

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Authors
Spiegler, Juliane; Haertel, Christoph; Schulz, Lena; von Wurmb-Schwark, Nicole; Hoehn, Thomas; Kribs, Angela; Kuester, Helmut; Siegel, Jens; Wieg, Christian; Weichert, Jan; Herting, Egbert; Goepel, Wolfgang
Abstract
The increasing rates of preterm birth among twins implicate that solid data on associated risks and outcomes are required. Assessment of zygosity is often based on clinical criteria (evaluation of placenta; same gender, birth weight discordance as surrogate criteria for monochorionic/monozygotic twins). The aim of this study was to compare clinical versus genetic assessment of zygosity and to compare causes of preterm delivery as well as outcome data of very-low-birth-weight (VLBW; birth weight <1,500 g) twins stratified to zygosity. In a multicenter study, we selected n = 176 sets of same gender twins and determined zygosity genetically. In a subgroup of 123 sets of twins, the attending physicians at the study centers were asked to document the parameter 'zygosity' (monozygotic/dizygotic) on the basis of their clinical judgment. Concordance between genetic and clinical assessment was 62.7% for monozygotic twins and 88.9% for dizygotic twins, respectively. Outcome parameters (death, BPD, ROP, NEC, IVH) were comparable in both groups. Genetically dizygotic twins were significantly more often born due to intrauterine infection (33% vs. 20% in monozygotic twins, p < .01) and antenatal antibiotics were more frequently given to mothers of dizygotic twins (62% vs. 47% in monozygotic twins, p < .01). Obstetric complications such as twin-twin-transfusion-syndrome were only seen in monozygotic twins as expected. The unexpected increase of antenatal antibiotic treatment and birth due to intrauterine infection in dizygotic twins should be confirmed in additional VLBW twin-cohorts.
Issue Date
2012
Status
published
Publisher
Cambridge Univ Press
Journal
Twin Research and Human Genetics 
ISSN
1832-4274

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