B. Luke et al., THE ROLE OF FETAL GROWTH RESTRICTION AND GESTATIONAL-AGE ON LENGTH OFHOSPITAL STAY IN TWIN INFANTS, Obstetrics and gynecology, 81(6), 1993, pp. 949-953
Objective: To evaluate the association between length of gestation and
fetal growth restriction (FGR) and the role of FGR in neonatal morbid
ity as determined by length of hospital stay among newborn twins. Meth
ods: Using a race-, gender-, and gestational age-specific birth weight
and length of hospital stay singleton standard, 490 twin infants were
classified as FGR (at or below the tenth percentile) or non-FGR (abov
e the tenth percentile). Length of stay and length-of-stay ratio (twin
stay divided by the 50th percentile singleton stay) were calculated f
or each twin. Analysis included stepwise multiple regression for lengt
h of stay and length-of-stay ratio, and analysis of variance with main
effects and second-order interactions for the length-of-stay measures
using factors significant in the multiple regression models. Results:
For length of stay, significant factors in the multiple regression mo
del included respiratory distress syndrome (RDS), gestation category,
FGR, sepsis, time of birth (1979-1984 versus 1985-1989), and cesarean
delivery. For length-of-stay ratio, significant factors included FGR,
gestation category, sepsis, period of birth, cesarean delivery, and hy
perbilirubinemia. The analysis of variance showed that RDS had the gre
atest effect on length of stay, whereas FGR had the greatest effect on
length-of-stay ratio. For both dependent variables, the effect of FGR
was magnified when compounded by significant neonatal complications (
RDS, sepsis, hyperbilirubinemia) or gestation category. Conclusions: F
etal growth restriction is a major factor in the neonatal morbidity of
twins. Early recognition of and interventions for FGR in twin gestati
ons should be a primary goal for reducing both immediate and long-term
adverse outcomes.