Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-26T14:09:51.188Z Has data issue: false hasContentIssue false

The Childhood Growth of Twin Children

Published online by Cambridge University Press:  01 August 2014

B. Luke*
Affiliation:
Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, Michigan
S. Leurgans
Affiliation:
Department of Preventive Medicine, Rush Medical College, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois
L. Keith
Affiliation:
Department of Obstetrics and Gynecology, Northwestern University Medical School Chicago, Illinois Center for the Study of Multiple Birth, Chicago, Illinois
D. Keith
Affiliation:
Center for the Study of Multiple Birth, Chicago, Illinois
*
Dept. Obstetrics and Gynecology, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, Michigan 48109-0264, USA

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

The objective of this study was to assess the childhood growth of twin children in terms of the effects of intrauterine growth retardation (IUGR) and discordancy at birth on the incidence and severity of stunting and discordancy in current height and weight. The study was part of a cross-sectional field project conducted at the Annual Twins Days Festival in Twinsburg. Ohio, USA, during 1990, 1991, and 1993, and including all twin children between 2 and 12 years of age. Mothers of twins were interviewed regarding their children's birthweights and gestational age; the twin children were measured for their current heights and weights. The study population included 990 twin children, including 555 boys and 435 girls, of which there were 254 boy pairs and 194 girl pairs. Birthweight for gestational age and current weight and height were each converted into Z-scores and characterized as severe (Z-score <−2,0), or moderate IUGR or stunting (Z-score > −2.0 and < −1.2). For the present study discordancy in birthweight, and current height and weight was calculated for like-gender twin pairs. Only twin children with severe IUGR at birth showed an increased risk of stunting in their current height or weight, and this risk was only for moderate, not severe, stunting. Boy twins with severe IUGR at birth were at increased risk of moderate stunting in their current weight (OR 2.67, 95% CI 1.55, 4.58, P = 0.002), while girl twins with severe IUGR at birth were at increased risk of moderate stunting in their current height (OR 4,09, 95% CI 1.49, 10.99, p = 0.003). Among like-gender twin pairs, there were no differences in mean or categories of birthweight or current weight discordancy, but boy twin pairs did show a significantly greater proportion of current weight discordancy compared to girl twin pairs (p = 0.005). Overall, there was a significant tendency for differences in height and weight between like-gender twin pairs to disappear over time, with the effect being greater for boy twin pairs. We conclude from these findings that twin children tend to overcome growth retardation and discordancy present at birth, and although children who had severe IUGR or discordancy at birth were more likely to have some residual moderate stunting or discordancy in height or weight, they still tended to be within normal values for their gender and current age.

Type
Research Article
Copyright
Copyright © The International Society for Twin Studies 1995

References

REFERENCES

1. Abraham, S (1979): Weight by height and age for adults 18-74 years, United States, 1971-74. Vital and Health Statistics: Series 11, Data from the National Health Survey; No. 208. DHEW Pub. No. (PHS) 79-1656. Hyattsville, Md.Google Scholar
2. Babson, SG, Phillips, DS (1973): Growth and development of twins dissimilar in size at birth. New Engl J Med 289: 937940.CrossRefGoogle ScholarPubMed
3. Blickstein, I, Shoam-Schwartz, Z, Lancet, M, Borenstein, R (1987): Characterization of the growth-discordant twin. Obstet Gynecol 70: 1115.Google Scholar
4. Blickstein, I, Shoman-Schwartz, Z, Lancet, M (1988): Growth discordancy in appropriate for gestational age, term twins. Obstet Gynecol 72: 585–4.Google Scholar
5. Bronsteen, R, Goyert, G, Bottoms, S (1989): Classification of twins and neonatal morbidity. Obstet Gynecol 74: 98101.Google Scholar
6. Crane, JP, Tomich, PG, Kopta, M (1980): Ultrasonic growth patterns in normal and discordant twins. Obstet Gynecol 55: 678683.Google Scholar
7. Dibley, MJ, Staehling, N, Nieburg, P; Trowbridge, FL (1987): Interpretation of Z-score anthropometric indicators derived from the international growth reference. Am J Clin Nutr 46: 749–62.Google Scholar
8. Erkkola, R, Ala-Mello, S, Piiroinen, O, Kero, P, Sillanpaa, M (1985): Growth discordancy in twin pregnancies: a risk factor not detected by measurements of biparietal diameter. Obstet Gynecol 66: 203–6.Google Scholar
9. Luke, B, Witter, FR, Abbey, H, Feng, TI, Namnoun, AB, Johnson, TRB (1991): Gestational age-specific birthweights of twins versus singletons. Acta Genet Med Gemellol 40: 6976.Google ScholarPubMed
10. Luke, B, Keith, LG (1992): The contribution of singletons, twins, and triplets to low birthweight, infant mortality, and handicap in the United States. J Reprod Med 37: 661–6.Google Scholar
11. Luke, B, Minogue, J, Witter, Fr (1993): The role of fetal growth restriction and gestational age on lenght of hospital stay in twin infants. Obstet Gynecol 81: 4953.Google Scholar
12. Luke, B (1994): The changing pattern of multiple births in the United States: maternal and infant characteristics, 1973 and 1990. Obstet Gynecol 84: 101–6.Google ScholarPubMed
13. Luke, B, Leurgans, S (1996): Maternal weight gains in ideal twin pregnancies. J Am Dietet Assoc; 96: 178181.Google Scholar
14. Najjar, MF and Rowland, M (1987): Anthropometric reference data and prevalence of overweight, United States, 1976-80. Vital and Health Statistics. Series 11, No. 238. DHHS Pub. No. (PHS) 87-1688. Publich Health Service. Washington, DC.Google Scholar
15. O'Brien, WF, Knuppel, RA, Scerbo, JC, Rattan, PK (1986): Birth weight in twins: an analysis of discordancy and growth retardation. Obstet Gynecol 67: 483–6.Google Scholar
16. Philip, AGS (1981): Term twins with discordant birth weights: observations at birth and one year. Acta Genet Med Gemellol 30: 203212.Google Scholar
17. Ventura, SJ, Martin, JA, Taffel, SM, Mathews, TJ, Clarke, SC (1995): Advance report of final natality statistics, 1993. Monthly Vital Statistics Report, Vol. 44, No. 3, Suppl. Hyattsville, MD: National Center for Health Statistics.Google Scholar
18. Williams, RL, Creasy, RK, Cumingham, GC, Hawes, WE, Norris, FD, Tashiro, M (1982): Fetal growth and perinatal viability in California. Obstet Gynecol 89: 624–32.Google Scholar
19. Wilson, RS (1985): Risk and resilience in early mental development. Dev Psychol 21: 795805.Google Scholar
20. Wilson, RS (1986): Growth and development of human twins. In Falkner, F and Tanner, JM (eds). Human Growth, A Comprehensive Treatise, second edition. New York: Plenum Press, pp. 197211.Google Scholar
21. Ylitalo, V, Kero, P, Erkkola, R (1988): Neurological outcome of twins dissimilar in size at birth. Early Human Dev 17: 245255.Google Scholar