{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T14:14:51Z","timestamp":1791728091720,"version":"4.3.4"},"reference-count":49,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T00:00:00Z","timestamp":1704931200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Most of the published literature on selective fetal growth restriction (sFGR) has focused on monochorionic twin pregnancies. The aim of this systematic review was to report on the outcome of dichorionic diamniotic (DCDA) twin pregnancies complicated by sFGR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>MEDLINE, EMBASE and The Cochrane Library databases were searched. The inclusion criteria were DCDA twin pregnancies complicated by sFGR. The outcomes explored were intrauterine death (IUD), neonatal death and perinatal death (PND), survival of at least one and both twins, preterm birth (PTB) (either spontaneous or iatrogenic) prior to 37, 34, 32 and 28\u2009weeks' gestation, pre\u2010eclampsia (PE) or gestational hypertension, neurological, respiratory and infectious morbidity, Apgar score &lt;\u20097 at 5\u2009min, necrotizing enterocolitis, retinopathy of prematurity and admission to the neonatal intensive care unit (NICU). A composite outcome of neonatal morbidity, defined as the occurrence of respiratory, neurological or infectious morbidity, was also evaluated. Random\u2010effects meta\u2010analysis was used to analyze the data, and results are reported as pooled proportion or odds ratio (OR) with 95%\u2009CI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirteen studies reporting on 1339 pregnancies with sFGR and 6316 pregnancies without sFGR were included. IUD occurred in 2.6% (95%\u2009CI, 1.1\u20134.7%) of fetuses from DCDA pregnancies with sFGR and 0.6% (95%\u2009CI, 0.3\u20139.7%) of those from DCDA pregnancies without sFGR, while the respective values for PND were 5.2% (95%\u2009CI, 3.5\u20137.3%) and 1.7% (95%\u2009CI, 0.1\u20135.7%). Spontaneous or iatrogenic PTB before 37\u2009weeks complicated 84.1% (95%\u2009CI, 55.6\u201399.2%) of pregnancies with sFGR and 69.1% (95%\u2009CI, 45.4\u201388.4%) of those without sFGR. The respective values for PTB before 34, 32 and 28\u2009weeks were 18.4% (95%\u2009CI, 4.4\u201338.9%), 13.0% (95%\u2009CI, 9.5\u201317.1%) and 1.5% (95%\u2009CI, 0.6\u20132.3%) in pregnancies with sFGR and 10.2% (95%\u2009CI, 3.1\u201320.7%), 7.8% (95%\u2009CI, 6.8\u20139.0%) and 1.8% (95%\u2009CI, 1.3\u20132.4%) in those without sFGR. PE or gestational hypertension complicated 19.9% (95%\u2009CI, 12.4\u201328.6%) of pregnancies with sFGR and 12.8% (95%\u2009CI, 10.4\u201315.4%) of those without sFGR. Composite morbidity occurred in 28.2% (95%\u2009CI, 7.8\u201355.1%) of fetuses from pregnancies with sFGR and 13.9% (95%\u2009CI, 6.5\u201323.5%) of those from pregnancies without sFGR. When stratified according to the sFGR status within a twin pair, composite morbidity occurred in 39.0% (95%\u2009CI, 11.1\u201371.5%) of growth\u2010restricted fetuses and 29.9% (95%\u2009CI, 3.5\u201365.0%) of appropriately grown fetuses (OR, 1.9 (95%\u2009CI, 1.7\u20133.1)), while the respective values for PND were 3.0% (95%\u2009CI, 1.8\u20134.5%) and 1.6% (95%\u2009CI, 0.9\u20132.6%) (OR, 2.1 (95%\u2009CI, 1.0\u20134.1)). On risk analysis, DCDA pregnancies complicated by sFGR had a significantly higher risk of IUD (OR, 5.2 (95%\u2009CI, 3.2\u20138.6)) and composite morbidity or admission to the NICU (OR, 3.2 (95%\u2009CI, 1.9\u20135.6)) compared to those without sFGR, while there was no difference in the risk of PTB before 34\u2009weeks (\n                      <jats:italic>P\u2009=<\/jats:italic>\n                      \u20090.220) or PE\/gestational hypertension (\n                      <jats:italic>P\u2009=<\/jats:italic>\n                      \u20090.210).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      DCDA twin pregnancies complicated by sFGR are at high risk of perinatal morbidity and mortality. The findings of this systematic review are relevant for counseling and management of complicated DCDA twin pregnancies, in which twin\u2010specific, rather than singleton, outcome data should be used. \u00a9 2023 The Authors.\n                      <jats:italic>Ultrasound in Obstetrics &amp; Gynecology<\/jats:italic>\n                      published by John Wiley &amp; Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.26302","type":"journal-article","created":{"date-parts":[[2023,7,31]],"date-time":"2023-07-31T02:35:11Z","timestamp":1690770911000},"page":"164-172","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Selective fetal growth restriction in dichorionic diamniotic twin pregnancy: systematic review and meta\u2010analysis of pregnancy and perinatal outcomes"],"prefix":"10.1002","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7546-8025","authenticated-orcid":false,"given":"F.","family":"D'Antonio","sequence":"first","affiliation":[{"name":"Center for Fetal Care and High\u2010Risk Pregnancy University of Chieti  Chieti Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2329-4470","authenticated-orcid":false,"given":"S.","family":"Prasad","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"},{"name":"Twins Trust Centre for Research and Clinical Excellence St George's University Hospital, St George's University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Masciullo","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit St George's University Hospitals NHS Foundation Trust, University of London  London UK"},{"name":"Twins Trust Centre for Research and Clinical Excellence St George's University Hospital, St George's University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0219-3283","authenticated-orcid":false,"given":"N.","family":"Eltaweel","sequence":"additional","affiliation":[{"name":"Division of Biomedical Science, Warwick Medical School University of Warwick, University Hospital of Coventry and Warwickshire  Coventry UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"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"},{"name":"Twins Trust Centre for Research and Clinical Excellence St George's University Hospital, St George's University of London  London UK"},{"name":"Fetal Medicine Unit, Liverpool Women's Hospital University of Liverpool  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,1,11]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"MBRRACE\u2010UK 2019 Perinatal Confidential Enquiry: Stillbirths and neonatal deaths in twin pregnancies","author":"Draper ES","year":"2021"},{"key":"e_1_2_7_3_1","unstructured":"Gestation\u2010specific Infant Mortality in England and Wales\u00a0\u2013\u00a0Office for National Statistics [Internet].https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/healthandsocialcare\/causesofdeath\/datasets\/gestationspecificinfantmortalityinenglandandwalesreferencetables. 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