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Birthweight Discordance, Risk Factors and its Impact on Perinatal Mortality Among Japanese Twins: Data From a National Project During 2001–2005

Published online by Cambridge University Press:  21 February 2012

Ruoyan Gai Tobe ,
Rintaro Mori ,
Norio Shinozuka ,
Takahiko Kubo  and
Kazuo Itabashi
Ruoyan Gai Tobe
Affiliation:
Department of Global Health Policy, Graduate School of Medicine, the University of Tokyo, Japan.
Rintaro Mori*
Affiliation:
Department of Global Health Policy, Graduate School of Medicine, the University of Tokyo, Japan. rintaromori@gmail.com
Norio Shinozuka
Affiliation:
Laboratory for Fetal Medicine Research, Kanagawa, Japan.
Takahiko Kubo
Affiliation:
Division of Obstetrics, Department of Maternal-Fetal and Neonatal Medicine, National Center for Child Health and Development, Tokyo, Japan.
Kazuo Itabashi
Affiliation:
Department of Pediatrics, Showa University, Japan.
*
*Address for correspondence: Dr. Rintaro Mori (MD, PhD, MSc, FRCPCH), Department of Global Health Policy, Graduate School of Medicine, the University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 1130033, Japan.

Abstract

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Our aims were to assess the incidence of birthweight discordance of twins, to explore risk factors and its impact on perinatal mortality, and to quantify the risks at different severity of birthweight discordance in Japan, by using a nationwide obstetric database. There were 10,828 pairs of twins, born from 2001 to 2005 recorded in the database of the national Perinatal Health Care Project, fully enrolled. The overall incidence of birthweight discordance was 47.34%. The incidence of mild, severe and extremely severe discordance was 19.26%, 10.21% and 17.87%, respectively. The incidence of birthweight discordance in Japan is much higher than that in other countries, particularly at higher severity level. By linear regression model, our study added independent factors of primiparity (p < .001), sex composition (p < .001), chorionicity (p < .001), gestational age (p < .001), and delivery mode (p < .001) in determining birthweight discordance percentage. Maternal age and application of assisted reproduction technologies (ART) didn't significantly influence the birthweight discordance. The birthweight discordance is closely associated with gestational age and affected discharge mortality. From 25% of birthweight discordance, risk to discharge mortality tended to significantly increase, suggesting it should be added as a reference for clinical practices.

Keywords

birthweight discordancegestational ageperinatal mortalitytwinJapan
Type
Articles
Information
Twin Research and Human Genetics , Volume 13 , Issue 5 , 01 October 2010 , pp. 490 - 494
Copyright
Copyright © Cambridge University Press 2010