Abstract：
To compare morbidity, as measured by length of stay in the neonatal intensive care unit (NICU), in twin and singleton gestations classified as small-for-gestational age (SGA) according to estimated fetal weight < 10th percentile on twin or singleton growth charts.
NICU length of stay was compared in 1150 twins and 29 035 singletons that underwent ultrasound assessment between 35 + 0 and 36 + 6 weeks\' gestation. Estimated fetal weight was obtained from measurements of head circumference, abdominal circumference and femur length using the Hadlock formula. Gestational age was derived from the first-trimester crown-rump length measurement, using the larger of the two twins. Singletons and twins were compared in terms of NICU admission rate and length of stay according to classification as SGA by the Fetal Medicine Foundation singleton and twin reference distributions.
The overall proportions of twins and singletons admitted to NICU were similar (7.3% vs 7.4%), but twins tended to have longer lengths of stay in NICU (≥ 7 days: 2.4% vs 0.8%; relative risk (RR), 3.0 (95% CI, 1.6-4.4)). Using the singleton chart, a higher proportion of twins were classified as SGA compared with singletons (37.6% vs 7.0%). However, the proportion of SGA neonates entering NICU was similar (10.2% for twins and 10.1% for singletons) and the proportion of SGA neonates spending ≥ 7 days in NICU was substantially higher for twins compared with singletons (3.7% vs 1.4%; RR, 2.6 (95% CI, 1.4-4.7)).
When singleton charts are used to define SGA in twins and in singletons, there is a greater degree of growth-related neonatal morbidity amongst SGA twins compared with SGA singletons. Consequently, singleton charts do not inappropriately overdiagnose fetal growth restriction in twins and they should be used for monitoring fetal growth in both twins and singletons. © 2023 International Society of Ultrasound in Obstetrics and Gynecology.
NICU length of stay was compared in 1150 twins and 29 035 singletons that underwent ultrasound assessment between 35 + 0 and 36 + 6 weeks\' gestation. Estimated fetal weight was obtained from measurements of head circumference, abdominal circumference and femur length using the Hadlock formula. Gestational age was derived from the first-trimester crown-rump length measurement, using the larger of the two twins. Singletons and twins were compared in terms of NICU admission rate and length of stay according to classification as SGA by the Fetal Medicine Foundation singleton and twin reference distributions.
The overall proportions of twins and singletons admitted to NICU were similar (7.3% vs 7.4%), but twins tended to have longer lengths of stay in NICU (≥ 7 days: 2.4% vs 0.8%; relative risk (RR), 3.0 (95% CI, 1.6-4.4)). Using the singleton chart, a higher proportion of twins were classified as SGA compared with singletons (37.6% vs 7.0%). However, the proportion of SGA neonates entering NICU was similar (10.2% for twins and 10.1% for singletons) and the proportion of SGA neonates spending ≥ 7 days in NICU was substantially higher for twins compared with singletons (3.7% vs 1.4%; RR, 2.6 (95% CI, 1.4-4.7)).
When singleton charts are used to define SGA in twins and in singletons, there is a greater degree of growth-related neonatal morbidity amongst SGA twins compared with SGA singletons. Consequently, singleton charts do not inappropriately overdiagnose fetal growth restriction in twins and they should be used for monitoring fetal growth in both twins and singletons. © 2023 International Society of Ultrasound in Obstetrics and Gynecology.
摘要：
目的：使用新生儿重症监护病房（NICU）的住院时间来衡量发病率，目的是根据小于胎龄分类(SGA),使用双胞胎的第10百分位数或单胎的第10百分位数比较双胞胎和单胎.
方法：比较了1,150例双胞胎和29,035例单胎新生儿的NICU住院时间，这些新生儿均在妊娠350至366周进行扫描。通过测量头围获得估计的胎儿体重，腹围和股骨长度使用Hadlock公式。使用两个双胞胎中较大的一个从孕早期的冠臀部长度测量中获得妊娠年龄。根据相对于胎儿医学基金会单胎和双胎参考分布的小分类，比较了单胎和双胞胎的NICU住院时间。
结果：双胞胎和单胎新生儿进入NICU的总比例相似（7.3％vs，7.4%)，但双胞胎往往在NICU住院时间更长(≥7天：2.4%的双胞胎与0.8%的单身人士，相对风险3.0，95%CI：1.6-4.4）。使用单例图，双胞胎被归类为SGA的比例比单胎高得多(37.2%vs.7.0%）。然而,进入NICU的SGA新生儿比例相似（双胞胎为10.3％，单胎为10.1％），并且双胞胎在NICU中花费≥7天的SGA新生儿比例明显高于单胎（3.7％与1.4%,风险比2.6，95%CI：1.1-4.7）。
结论：当使用单例图定义双胞胎和单例中的SGA时，SGA双胞胎中与生长相关的新生儿发病率高于SGA单胎。因此,在双胞胎中使用单例图不会过度诊断胎儿生长受限，它们应用于监测双胞胎和单胎的胎儿生长。本文受版权保护。保留所有权利。
方法：比较了1,150例双胞胎和29,035例单胎新生儿的NICU住院时间，这些新生儿均在妊娠350至366周进行扫描。通过测量头围获得估计的胎儿体重，腹围和股骨长度使用Hadlock公式。使用两个双胞胎中较大的一个从孕早期的冠臀部长度测量中获得妊娠年龄。根据相对于胎儿医学基金会单胎和双胎参考分布的小分类，比较了单胎和双胞胎的NICU住院时间。
结果：双胞胎和单胎新生儿进入NICU的总比例相似（7.3％vs，7.4%)，但双胞胎往往在NICU住院时间更长(≥7天：2.4%的双胞胎与0.8%的单身人士，相对风险3.0，95%CI：1.6-4.4）。使用单例图，双胞胎被归类为SGA的比例比单胎高得多(37.2%vs.7.0%）。然而,进入NICU的SGA新生儿比例相似（双胞胎为10.3％，单胎为10.1％），并且双胞胎在NICU中花费≥7天的SGA新生儿比例明显高于单胎（3.7％与1.4%,风险比2.6，95%CI：1.1-4.7）。
结论：当使用单例图定义双胞胎和单例中的SGA时，SGA双胞胎中与生长相关的新生儿发病率高于SGA单胎。因此,在双胞胎中使用单例图不会过度诊断胎儿生长受限，它们应用于监测双胞胎和单胎的胎儿生长。本文受版权保护。保留所有权利。
