{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T04:59:13Z","timestamp":1781153953693,"version":"3.54.1"},"reference-count":81,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003579","name":"University of Toronto","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003579","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine the risk of placental dysfunction associated with different ultrasound\u2010based phenotypes of impaired fetal growth in dichorionic twin pregnancies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Single tertiary centre.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>\n                      Patients with dichorionic twin pregnancies delivered at \u2265\u200932\n                      <jats:sup>0\/7<\/jats:sup>\n                      (2011\u20132023) (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009753).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Each twin fetus was classified into a distinct exposure group based on combinations of fetal weight percentile (categorised as AGA, mild SGA, or severe SGA) based on singleton\u2010 or twin\u2010specific growth chart, weight discordance and Doppler.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>Abnormal placental histopathology known to be associated with FGR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The rate of the primary outcome in the reference group (AGA, concordant growth, normal Doppler) was 12.8%. When using a singleton chart, isolated discordance and mild SGA were not associated with the primary outcome. Only isolated severe SGA (28.8%, aRR 2.47[1.52\u20134.03]), followed by severe SGA with discordant growth (41.9%, aRR 3.53[2.15\u20135.79]) and abnormal Doppler (54.7%, aRR 4.33[2.90\u20136.48]) showed significant associations with the primary outcome. In contrast, when using a twin\u2010specific chart, both isolated discordance (32.4%, aRR 2.63[1.46\u20134.73]) and mild SGA (28.2%, aRR 2.43[1.30\u20134.51]) were associated with the primary outcome. We propose three risk categories for late\u2010onset placenta\u2010mediated FGR based on the likelihood of the primary outcome: (1) possible small increase (&lt;\u20092\u2010fold); (2) moderate increase (2\u20133 fold); and (3) highest risk (&gt;\u20094\u2010fold).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The risk categories proposed in the current study can serve as a framework to inform the design of future trials and contribute to the development of guidelines for managing twin pregnancies affected by late\u2010onset FGR.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.70215","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T08:22:43Z","timestamp":1773217363000},"page":"1616-1628","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk of Placental Pathology Across Ultrasound\u2010Defined Phenotypes of Impaired Fetal Growth in Dichorionic Twins: A Retrospective Cohort Study"],"prefix":"10.1111","volume":"133","author":[{"given":"Ala","family":"Essalah","sequence":"first","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine, Department of Obstetrics and Gynaecology, Sunnybrook Health Sciences Center, Temerty Faculty of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Kingdom","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, Temerty Faculty of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4443-388X","authenticated-orcid":false,"given":"Liran","family":"Hiersch","sequence":"additional","affiliation":[{"name":"Lis Maternity Hospital, Sourasky Medical Center, and Gray Faculty of Medical and Health Science Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon","family":"Barrett","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology McMaster University  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Watson","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine, Department of Obstetrics and Gynaecology, Sunnybrook Health Sciences Center, Temerty Faculty of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2704-1385","authenticated-orcid":false,"given":"Nir","family":"Melamed","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine, Department of Obstetrics and Gynaecology, Sunnybrook Health Sciences Center, Temerty Faculty of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,11]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2008.04.010"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-200203000-00020"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41581-019-0119-6"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2020.05.010"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15884"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.22134"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.13522"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)62049-3"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)16809-8"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c7087"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/ppe.12570"},{"issue":"13","key":"e_1_2_12_13_1","first-page":"1","article-title":"Births: Final Data for 2018","volume":"68","author":"Martin J. 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