Fetal growth restriction inhibits childhood growth despite catch-up in discordant identical twins: an observational cohort study
Main finding · Height SDSResult — go to the resultMedian difference 0.5 SDS 95% CI 0.4–0.7Authors' conclusion
Identical twins with discordant prenatal growth maintain a modest but significant difference in height, weight, and head circumference, indicating a persistent, inhibitory effect of an adverse intrauterine environment on childhood growth.
Study context
- Population
- Monochorionic twins with selective FGR (sFGR) born 2002–2017 (aged 3–17 years), Netherlands; median age 11 (IQR 8–13) years
- Participants
- 94 twins47 twin pairs
- Exposure
- Smaller vs larger twin at birth within discordant identical twin pairs
- Outcome
- Height SDS
- Follow-up
- Last measurement
Methodological detailsmonochorionic twins with selective fetal growth restriction (FGR), mixed-effects model
- Monochorionic twins with selective FGR
- Mixed-effects model
Main finding
As reported in the abstract
Median difference
0.5 SDS
95% CI 0.4–0.7
P < 0.001
By group
Smaller twins
−0.6
SDS
Larger twins
−0.3
SDS
Larger twinsvs Smaller twins
median difference 0.5 SDS (95% CI 0.4–0.7); P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | Smaller twins | Larger twins | Median difference (SDS) (95% CI) | P value | |
|---|---|---|---|---|---|
| Weight SDS · last measurement | −0.5 SDS | −0.1 SDS | 0.8 (0.5–1.0) | P < 0.001 | |
| Head circumference SDS · last measurement | −0.5 SDS | 0.2 SDS | 0.8 (0.6–0.9) | P < 0.001 | |
| −0.500.511.5Difference, SDS (linear scale) |
Growth trajectory
- Differences persisted until age 17
- Smaller twins showed rapid catch-up growth in the first 2 years and reached target height range between 8 and 11 years
Original publication
Fetal growth restriction inhibits childhood growth despite catch-up in discordant identical twins: an observational cohort study. Eur J Endocrinol. Published 7 August 2023. doi:10.
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