{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T19:15:58Z","timestamp":1785006958306,"version":"3.55.0"},"reference-count":17,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T00:00:00Z","timestamp":1709251200000},"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;amp; Gyne"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare morbidity, as measured by length of stay in the neonatal intensive care unit (NICU), in twin and singleton gestations classified as small\u2010for\u2010gestational age (SGA) according to estimated fetal weight &lt;\u200910<jats:sup>th<\/jats:sup> percentile on twin or singleton growth charts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>NICU length of stay was compared in 1150 twins and 29\u2009035 singletons that underwent ultrasound assessment between 35\u2009+\u20090 and 36\u2009+\u20096\u2009weeks' gestation. Estimated fetal weight was obtained from measurements of head circumference, abdominal circumference and femur length using the Hadlock formula. Gestational age was derived from the first\u2010trimester crown\u2013rump length measurement, using the larger of the two twins. Singletons and twins were compared in terms of NICU admission rate and length of stay according to classification as SGA by the Fetal Medicine Foundation singleton and twin reference distributions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The overall proportions of twins and singletons admitted to NICU were similar (7.3% <jats:italic>vs<\/jats:italic> 7.4%), but twins tended to have longer lengths of stay in NICU (\u2265\u20097\u2009days: 2.4% <jats:italic>vs<\/jats:italic> 0.8%; relative risk (RR), 3.0 (95%\u2009CI, 1.6\u20134.4)). Using the singleton chart, a higher proportion of twins were classified as SGA compared with singletons (37.6% <jats:italic>vs<\/jats:italic> 7.0%). However, the proportion of SGA neonates entering NICU was similar (10.2% for twins and 10.1% for singletons) and the proportion of SGA neonates spending \u2265\u20097\u2009days in NICU was substantially higher for twins compared with singletons (3.7% <jats:italic>vs<\/jats:italic> 1.4%; RR, 2.6 (95%\u2009CI, 1.4\u20134.7)).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>When singleton charts are used to define SGA in twins and in singletons, there is a greater degree of growth\u2010related neonatal morbidity amongst SGA twins compared with SGA singletons. Consequently, singleton charts do not inappropriately overdiagnose fetal growth restriction in twins and they should be used for monitoring fetal growth in both twins and singletons. \u00a9 2023 International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.27499","type":"journal-article","created":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T01:09:51Z","timestamp":1695604191000},"page":"365-370","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Incidence of neonatal morbidity in small\u2010for\u2010gestational\u2010age twins based on singleton and twin charts"],"prefix":"10.1002","volume":"63","author":[{"given":"D.","family":"Wright","sequence":"first","affiliation":[{"name":"Institute of Health Research University of Exeter  Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Wright","sequence":"additional","affiliation":[{"name":"Institute of Health Research University of Exeter  Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Rehal","sequence":"additional","affiliation":[{"name":"Harris Birthright Research Centre for Fetal Medicine King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5856-6072","authenticated-orcid":false,"given":"A.","family":"Syngelaki","sequence":"additional","affiliation":[{"name":"Harris Birthright Research Centre for Fetal Medicine King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4633-4738","authenticated-orcid":false,"given":"S. E.","family":"Kristensen","sequence":"additional","affiliation":[{"name":"Copenhagen University Hospital Rigshospitalet  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O. B.","family":"Petersen","sequence":"additional","affiliation":[{"name":"Copenhagen University Hospital Rigshospitalet  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. H.","family":"Nicolaides","sequence":"additional","affiliation":[{"name":"Harris Birthright Research Centre for Fetal Medicine King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,3]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1997.tb10948.x"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17470"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.21892"},{"key":"e_1_2_7_5_1","volume-title":"Twin and Triplet Pregnancy","year":"2019"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/OGX.0000000000000803"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19073"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.27514"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10040643"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2022.01.027"},{"issue":"86","key":"e_1_2_7_11_1","first-page":"e1","article-title":"Early vaginal progesterone versus placebo in twin pregnancies for the prevention of spontaneous preterm birth: a randomized, double\u2010blind trial","volume":"224","author":"Rehal A","year":"2021","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.26036"},{"key":"e_1_2_7_13_1","unstructured":"R Core Development Team.R: A language and environment for statistical computing.2019.https:\/\/www.R\u2010project.org\/."},{"key":"e_1_2_7_14_1","unstructured":"CantyA RipleyB.boot: bootstrap R (S\u2010Plus) functions. 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