Journal of Perinatal Medicine
Official Journal of the World Association of Perinatal Medicine
Editor-in-Chief: Dudenhausen, Joachim W.
Editorial Board Member: / Bancalari, Eduardo / Greenough, Anne / Genc, Mehmet R. / Chervenak, Frank A. / Chappelle, Joseph / Bergmann, Renate L. / Bernardes, J.F. / Bevilacqua, G. / Blickstein, Isaac / Cabero Roura, Luis / Carbonell-Estrany, Xavier / Carrera, Jose M. / D`Addario, Vincenzo / D'Alton, MD, Mary E. / Dimitrou, G. / Grunebaum, Amos / Hentschel, Roland / Köpcke, W. / Kawabata, Ichiro / Keirse, Marc J.N.C. / Kurjak M.D., Asim / Lee, Ben H. / Levene, Malcolm / Lockwood, Charles J. / Marsal, Karel / Makatsariya, Alexander / Nishida, Hiroshi / Ogata, Edward / Papp, Zoltán / Pejaver, Ranjan Kumar / Pooh, Ritsuko K. / Romero, Roberto / Saugstad, Ola D. / Schenker, Joseph G. / Sen, Cihat / Seri, Istvan / Vetter, Klaus / Winn, Hung N. / Young, Bruce K. / Zimmermann, Roland
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The source of error in the estimation of intertwin birth weight discordance
1Prenatal Diagnosis Center, Hospital Garcia de Orta, Almada, Portugal
2Department of Obstetrics and Gynecology, Kaplan Medical Center, Rehovot, and the Hadassah-Hebrew University School of Medicine, Jerusalem, Israel
Citation Information: Journal of Perinatal Medicine. Volume 38, Issue 6, Pages 671–674, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: 10.1515/jpm.2010.104, August 2010
- Published Online:
Objective: To assess the accuracy of paired estimated fetal weights (EFWs) to predict three levels of twin birth weight discordance (>15%, >20% and >25%).
Method: A cohort of twin pairs underwent ultrasound examinations within 2 weeks from birth. We calculated the frequency of under- and overestimation of the actual birth weight (< or >10%, respectively) in the entire cohort as well in the subset of mono- and dichorionic pairs.
Results: Discordance was largely underestimated (observed 10.4±0.8% compared to actual 19.2±1.1%, P=0.001) because the larger twin was more frequently underestimated [30.6 vs. 17.7%, odds ratio (OR) 2.0, 95% confidence interval (CI) 1.1, 3.9 in the entire cohort, and 34.2 vs. 13.1%, OR 3.4, 95% CI 1.4, 8.4 in the dichorionic pairs]. Overall, the specificity for detecting the three levels of discordance was adequate (91.5–94.2%) but the sensitivity was poor (11.1–17.8%) and tended to decrease with increasing discordance level.
Conclusion: The poor ability of paired EFWs to diagnose birth weight discordance results from underestimation of the larger twin.
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