{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T12:33:28Z","timestamp":1769603608982,"version":"3.49.0"},"reference-count":14,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,2,13]],"date-time":"2020-02-13T00:00:00Z","timestamp":1581552000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The primary objective was to quantify the risk of perinatal mortality in non\u2010anomalous monochorionic monoamniotic (MCMA) twin pregnancies complicated by birth\u2010weight (BW) discordance. The secondary objectives were to investigate the effect of inpatient <jats:italic>vs<\/jats:italic> outpatient fetal monitoring on  the risk of mortality in weight\u2010discordant MCMA twin pregnancies, and to explore the predictive accuracy of BW discordance for perinatal mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This analysis included data on 242 MCMA twin pregnancies (484 fetuses) from three major research collaboratives on twin pregnancy (MONOMONO, STORK and NorSTAMP). The primary outcomes were the risks of intrauterine (IUD), neonatal (NND) and perinatal (PND) death, according to weight discordance at birth from \u2265 10% to \u2265 30%. The secondary outcomes were the association of inpatient <jats:italic>vs<\/jats:italic> outpatient fetal monitoring with the risk of mortality in weight\u2010discordant pregnancies, and the  accuracy of BW discordance in predicting mortality. Logistic regression and receiver\u2010operating\u2010characteristics\u2010curve analyses were used to analyze the data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The risk of IUD was significantly increased in MCMA twin pregnancies with BW  discordance \u2265 10% (odds ratio (OR), 2.2; 95% CI, 1.1\u20134.4; <jats:italic>P<\/jats:italic> = 0.022) and increased up to an OR of 4.4 (95% CI, 1.3\u201314.4; <jats:italic>P<\/jats:italic> = 0.001) in those with BW  discordance \u2265 30%. This association remained  significant on  multivariate logistic regression analysis for BW\u2010discordance cut\u2010offs \u2265 20%. However, weight discordance had low  predictive accuracy for mortality, with areas under the receiver\u2010operating\u2010characteristics curve of 0.60 (95% CI, 0.46\u20130.73), 0.52 (95% CI, 0.33\u20130.72) and 0.57 (95% CI, 0.45\u20130.68) for IUD, NND and PND, respectively. There was no difference in the risk of overall IUD, single IUD, double IUD, NND or PND between pregnancies managed as an inpatient compared with those managed as an outpatient, for any BW\u2010discordance cut\u2010off.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>MCMA twin pregnancies with BW discordance are at increased risk of fetal death,  signaling a need for increased levels of monitoring. Despite this, the predictive accuracy for mortality is low; thus, detection of BW discordance alone should not trigger intervention, such as iatrogenic delivery. The  current data do not demonstrate an advantage of inpatient over outpatient management in these cases. Copyright \u00a9 2019 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.20357","type":"journal-article","created":{"date-parts":[[2019,5,27]],"date-time":"2019-05-27T12:54:15Z","timestamp":1558961655000},"page":"332-338","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Weight discordance and perinatal mortality in monoamniotic twin pregnancy: analysis of MONOMONO, NorSTAMP and STORK multiple\u2010pregnancy cohorts"],"prefix":"10.1002","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0078-2113","authenticated-orcid":false,"given":"G.","family":"Saccone","sequence":"first","affiliation":[{"name":"Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine University of Naples Federico II  Naples Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2802-7670","authenticated-orcid":false,"given":"A.","family":"Khalil","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit St George's University Hospitals NHS Foundation Trust, University of London  London UK"},{"name":"Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute St George's University of London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5531-4301","authenticated-orcid":false,"given":"B.","family":"Thilaganathan","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit St George's University Hospitals NHS Foundation Trust, University of London  London UK"},{"name":"Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute St George's University of London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. V.","family":"Glinianaia","sequence":"additional","affiliation":[{"name":"Institute of Health &amp; Society Newcastle University  Newcastle upon Tyne UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6902-6095","authenticated-orcid":false,"given":"V.","family":"Berghella","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine, Department of Obstetrics and Gynecology Sidney Kimmel Medical College of Thomas Jefferson University  Philadelphia PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"D'Antonio","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University Hospital of Northern Norway  Troms\u00f8 Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"for the MONOMONO, NorSTAMP and STORK research collaboratives","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,2,13]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jp.7211457"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)14237-7"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/GCO.0000000000000160"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/jog.12014"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1744-4667.2012.00092.x"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/jmf.13.6.414.421"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001709"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19179"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19114"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1017\/thg.2012.65"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.18916"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.18966"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61602-X"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.06.054"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fuog.20357","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.20357","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/uog.20357","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.20357","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T22:01:06Z","timestamp":1694037666000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.20357"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,13]]},"references-count":14,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020,3]]}},"alternative-id":["10.1002\/uog.20357"],"URL":"https:\/\/doi.org\/10.1002\/uog.20357","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,2,13]]},"assertion":[{"value":"2019-03-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-05-20","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-02-13","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}