Can Fetal Weight Discordancy Measured by Ultrasound During Pregnancy Predict Maternal Complications and Neonatal Outcomes in Dichorionic Diamniotic Twins?

Purpose: The aim of this study was to determine the relationships between the estimated fetal weight discordancy, which was measured by ultrasound during pregnancy, and maternal pregnancy complications and neonatal outcomes in dichorionic diamniotic twin pregnancies.Methods: We conducted a retrospective review of the medical records of 320 twin pregnancies delivered at Chilgok Kyungpook National University Hospital between January 2011 and February 2020. This study included dichorionic diamniotic twin mothers who delivered between 32+1 and 38+0 weeks of gestation. Mothers who had one fetal demise, a major anomaly, or twin-specific complications were excluded. At 20–24 weeks and 28–32 weeks of gestation, participants were divided into 2 groups: discordant twins with an estimated fetal weight difference of more than 20% and concordant twins with a weight difference of less than 20%. The maternal complications and neonatal outcomes were compared between the two groups. Results: The incidences of preeclampsia and placenta previa were significantly higher in discordant twins measured between 20 and 24 weeks compared with concordant twins, but no statistical significance was found in the neonatal outcomes between the two groups. Delivery times were earlier and neonatal weights were lower in discordant twins measured between 28 and 32 weeks. Neonatal outcomes such as ventilator use and neurodevelopment were also significantly different. Conclusion: Discordance in estimated fetal weight measured by ultrasound between 20 and 24 weeks is a risk factor for maternal preeclampsia and placenta previa, whereas discordancy at 28–32 weeks can predict poor neonatal outcomes.