{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T14:03:03Z","timestamp":1791813783719,"version":"4.3.4"},"reference-count":52,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,7,4]],"date-time":"2018-07-04T00:00:00Z","timestamp":1530662400000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The primary aim of this systematic review was to explore the strength of association between birth\u2010weight (BW) discordance and perinatal mortality in twin pregnancy. The secondary aim was to ascertain the contribution of gestational age and growth restriction in predicting mortality in growth\u2010discordant twins.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>MEDLINE, EMBASE, CINAHL and \n<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicalTrials.gov\">ClinicalTrials.gov<\/jats:ext-link> databases were searched. Only studies reporting on the risk of mortality in twin pregnancies affected compared with those not affected by BW discordance were included. The primary outcomes explored were incidence of intrauterine death (IUD), neonatal death (NND) and perinatal death. Outcome was assessed separately for monochorionic (MC) and dichorionic (DC) twin pregnancies. Analyses were stratified according to BW discordance cut\u2010off (\u2265 15%, \u2265 20%, \u2265 25% and \u2265 30%) and selected gestational characteristics, including incidence of IUD or NND before and after 34 weeks' gestation, presence of at least one small\u2010for\u2010gestational age (SGA) fetus in the twin pair and both twins being appropriate\u2010for\u2010gestational age. Risk of mortality in the larger <jats:italic>vs<\/jats:italic> smaller twin was also assessed. Meta\u2010analyses using individual data random\u2010effects logistic regression and meta\u2010analyses of proportion were used to analyze the data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010two studies (10 877 twin pregnancies) were included in the analysis. In DC pregnancies, a higher risk of IUD, but not of NND, was observed in twins with BW discordance \u2265 15% (odds ratio (OR) 9.8, 95% CI, 3.9\u201329.4), \u2265 20% (OR 7.0, 95% CI, 4.15\u201311.8), \u2265 25% (OR 17.4, 95% CI, 8.3\u201336.7) and \u2265 30% (OR 22.9, 95% CI, 10.2\u201351.6) compared with those without weight discordance. For each cut\u2010off of BW discordance explored in DC pregnancies, the smaller twin was at higher risk of mortality compared with the larger one. In MC twin pregnancies, excluding cases affected by twin\u2013twin transfusion syndrome, twins with BW discordance \u2265 20% (OR 2.8, 95% CI, 1.3\u20135.8) or \u2265 25% (OR 3.2, 95% CI, 1.5\u20136.7) were at higher risk of IUD, compared with controls. MC pregnancies with \u2265 25% weight discordance were also at increased risk of NND (OR 4.66, 95% CI, 1.8\u201312.4) compared with those with concordant weight. The risk of IUD was higher when considering discordant pregnancies involving at least one SGA fetus. The overall risk of mortality in MC pregnancies was similar between the smaller and larger twin, except in those with BW discordance \u2265 20%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>DC and MC twin pregnancies discordant for fetal growth are at higher risk of IUD but not of NND compared with pregnancies with concordant BW. The risk of IUD in BW\u2010discordant DC and MC twins is higher when at least one fetus is SGA. Copyright \u00a9 2017 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.18966","type":"journal-article","created":{"date-parts":[[2017,11,20]],"date-time":"2017-11-20T14:33:12Z","timestamp":1511188392000},"page":"11-23","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":127,"title":["Weight discordance and perinatal mortality in twin pregnancy: systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7546-8025","authenticated-orcid":false,"given":"F.","family":"D'Antonio","sequence":"first","affiliation":[{"name":"Department of Clinical Medicine, Faculty of Health Sciences UiT \u2010 The Arctic University of Norway  Troms\u00f8 Norway"},{"name":"Department of Obstetrics and Gynaecology University Hospital of Northern Norway  Troms\u00f8 Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. 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