Specific growth velocity reference charts for monochorionic twin pregnancies

• Published in: International journal of gynecology and obstetrics Vol. 168; no. 2; pp. 783 - 789
• Main Authors: Zhang, Yan‐Hua, Chen, Lu, Zhan, Hong, Pan, Jiao'e, Zhao, Li, Zhao, Wei, Liang, Qiong‐Xin, Li, Xiao‐Qing, Wen, Hong
• Format: Journal Article
• Language: English
• Published: United States 01.02.2025
• Subjects: Adult; Birth Weight; estimated fetal weight; Female; fetal biometric parameter; Fetal Development - physiology; fetal growth velocity; Fetal Weight; Gestational Age; Growth Charts; Humans; Infant, Newborn; Linear Models; monochorionic twin pregnancies; Pregnancy; Pregnancy, Twin; Reference Values; Retrospective Studies; Twins, Monozygotic; Ultrasonography, Prenatal; fetal growth velocity; fetal biometric parameter; estimated fetal weight; monochorionic twin pregnancies
• ISSN: 0020-7292; 1879-3479; 1879-3479
• DOI: 10.1002/ijgo.15933

Objective We aimed to create specific growth velocity reference charts for monochorionic (MC) twin pregnancies and provide additional information for assessing fetal growth in MC twins. Study Design This retrospective study collected data from uncomplicated MC twins with serial ultrasound parameters. The four ultrasound parameters, including biparietal diameter, femur length, head circumference, and abdominal circumference, were used to calculate the estimated fetal weight (EFW). Multilevel linear regression models were applied to fit growth velocity charts for each biometric parameter and EFW. Analysis of variance was used to examine differences in birthweight by whether EFW velocity and EFW values were <10th or ≥10th percentiles. Results The final analysis encompassed a total of 5956 ultrasound examinations conducted on 487 MC twins. The growth velocity of four biparietal diameters exhibited a gradual decrease in a nearly linear fashion progressing from 18 to 37 gestational weeks. The EFW velocity increased steadily from 18 to 36 gestational weeks, reaching a peak of 178.2 g/week, and then the velocity gradually decreased until delivery. At 32 weeks for illustration, the lightest birth weight was observed when both EFW and EFW velocity were <10th percentile (1899 g). The study also found that birth weight was higher when EFW velocity was ≥10th percentile compared with <10th percentile, regardless of EFW being below or above the 10th percentile (2263 and 1906 g, respectively; P < 0.001). Conclusion We developed specific growth velocity reference charts for MC twins, which could provide a valuable reference point for a more precise evaluation of fetal growth in MC twins. Preliminary findings indicate that the inclusion of fetal growth velocity in monitoring fetal growth provides additional information beyond EFW alone. Synopsis We developed specific growth velocity reference charts for monochorionic twins, which could capture the dynamic changes that occur during fetal growth.