Birth Weight Variation between the First and the Second Twin in Spontaneously Conceived Twin Pregnancies Delivered in Alex Ekwueme Federal University Teaching Hospital Abakaliki: A 5-year Retrospective Study

Uche-Nwidagu Bridget Nkiruka¹, Nwafor Johnbosco Ifunanya^1, , Onyema Malachy Chizoba¹, Oliobi Wendy Chinwe¹, Okoye Paschal Chijioke¹ and Nweke Assumpta Nnenna¹

¹Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria

Cite this paper:
Uche-Nwidagu Bridget Nkiruka, Nwafor Johnbosco Ifunanya, Onyema Malachy Chizoba, Oliobi Wendy Chinwe, Okoye Paschal Chijioke and Nweke Assumpta Nnenna. Birth Weight Variation between the First and the Second Twin in Spontaneously Conceived Twin Pregnancies Delivered in Alex Ekwueme Federal University Teaching Hospital Abakaliki: A 5-year Retrospective Study. American Journal of Medical Sciences and Medicine. 2019; 7(3):54-59. doi: 10.12691/ajmsm-7-3-1

Abstract

Background: Twin pregnancies are associated with disturbed fetal growth. Studies have shown reduced fetal growth, compared to singletons, and also differences in birth weight between first and second twin. Hence, there is a need to evaluate this outcome among twin pregnancies delivered in our hospital. Aim: To determine the birth weight variation between the first and second twin in spontaneously conceived twin pregnancies delivered at the Alex Ekwueme Federal University Teaching Hospital Abakaliki. Materials and Methods: This was a 5-year retrospective study undertaken between January 2012 and December 31 2016 at our hospital. The study cohorts were parturients who were delivered twin pregnancies that were spontaneously conceived. Data collection was done using a pre-designed proforma; analysis was done using SPSS version 20. Result: During the study period, there were 11,932 deliveries and 378 were spontaneously conceived twin deliveries. This accounted for 3.2% of all hospital deliveries. The peak age group for twin gestation was 21-34 years 319(84.4%), 262(69.3%) were booked. Primigravidae were 101 (26.7%) while multiparas were 207 (54.8%) and grandmultiparas; 70 (18.5%). Those delivered through caesarean section were 186 (49.2%) while 176(42.0%) were delivered through the vaginal route. The Apgar score for the first twin in the first and fifth minute respectively were good in 287(75.9%) while in the second twin, 260(68.8%) suffered no asphyxia. Males were more in the first, 211 (58.8%) as well as in the second twins 209(55.3%). The mean birth weight of the first twin was 2.39kg while the mean birth weight of the second twin was 2.36kg. The first twin therefore weighed heavier than the second twin by 30g. Conclusion: Birth weight between the first and the second twin can vary depending on the gestational age, the socio-demographic status and the sex of the fetuses.

Keywords:
birth weight variation first twin second twin Abakaliki

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]	Richa S. Twin Pregnancy. In: Bedside Obstetrics and Gynecology. 1st edn. Jaypee Brothers Medical Publishers. 2010; 89-105.
[2]	Bush MC, Pernoll ML. multiple gestation. In: Current diagnosis and Treatment: Obstetrics and Gynecology. 11 edn. (ed); Alan HD, Nathan L, Langer N, Roman AS. 2010; 301-309.
[3]	Kilby MD, Oepkes D. Multiple Pregnancy. In: Dewhurst’s Textbook of Obstetrics and Gyneacology. 8th edn (ed) Edmond KD. Blackwell Publishing LTD 2012, 230-246.
[4]	Abudu OO, Anorlu RI. Multiple pregnancy. In: Agboola A. Textbook of Obstetrics and Gynecology for Medical Students. 2nd edn. Heinemanm Educational Books 2006: 373-380.
[5]	Onyiriuka AN. Twin Delivery; Incidence and Perinatal outcome in a Nigerian Mission Hospital. Bangledesh Journal of Medical Sciences. 2011; 10(1):45-46.
[6]	Eltahir ME, Gero S. differences in Anthropometric Measurements between Sudanese Newborn twins and Singleton. Twin Research and Human Genetics. 201.(13)1, 88-95.
[7]	Carla RI. The Management of Monochprionic-Diamniotic twins. Vanderbult University, Nov 30, 2012.
[8]	Jewell SE, Yip R. Increasing Trends in Plural Births in the United States. Obstet Gynecol 1995, 85:229-232.
[9]	Robert V, Mary G, Catherine D. twin birth weight standards. Article in Neonatology. Feb 2007.
[10]	Demanini S, Koo WW, Hoctman EM. Bone lean and fat mass of newborn twins versus singleton. Acta paediatrics, 2006; 59-596.
[11]	Robert CL, Algert CS, Tanya AN, Bowen JR, Shard AW. Prelabour caesarean delivery for twin pregnancies close to term. Association of prelabour delivery with reduced mortality in Twins near term in Obstetrics and Gynecology. 2015; 125: 103-10.
[12]	Sawsan AO, Jacqueline P, Kellie EM, Phyllus G, Cynthia M. Accuracy of Estimating fetal Weight and inter-twin weight discordancy by ultrasound in twin pregnancies in women with increased body mass index, 2014; JOGC, 2015.
[13]	Syeda BM, Sadia K. twin birth weight discordance: Associated factors and outcome. Journal of the college of Physicians and Surgeons. Parkinstan 2010, 20(6): 391-394.
[14]	Cohen SB, Elizur SE, Goldenberg M, Beiner M, Novikov I, Masluach S. et al. outcome of twin pregnancies with extreme weight discordancy. Am J perinatal 2001; 18:427-32.
[15]	Hollier LM, McIntire DD, Leveno KJ. Outcome of Twin pregnancies according to intrapair birth weight differences. Obstet Gynecol 1999; 94:1006-10.
[16]	Strobina DM, Ensminger Kim YJ, Nanda J. Mechanism fo maternal age differences in birth weight. Am J Epidemol 1995. 142: 504-514.
[17]	Liu YC, Blair EM. Predicted birth weight for singletons and twins. Twin Research 2002; 5:529-537.
[18]	Bleker OP, Breur W, Huidekoper BL. A Study of birth weight, placental weight and mortality of twins as compared to singletons. British Journ of Obs and Gyn. 1979; 86:111-118.
[19]	Min SJ, Luke B, Gillespie B, Min L, Newman RB, Mauldin JG, Wilter FR, Salman FA, O’Sullivan MJ. Birth weight references for twins. Am J Obstet Gynecol. 2000; 182:1250-1257.
[20]	Onyiriuka An. Low birth weight infants in Twin gestation. Nepal Journal of Obtet gynecol. 2011; 15(1): 37-41.
[21]	Onyiriuka AN. Intrapair birth weight discordance in twins. Annals of African Medicine. 2009; (8) 110-114.
[22]	Douglas A, Kenneth YC, Lee DC. The cost of low birth weight. The Quartely journal of Economics 2005; 1031-1083.
[23]	Yoon-mi H, Michelle L, Nicholas GM, Dorret IB, William GL, Matt M et al. a comparison of Twin birth weight data from Australia, the Netherlans, the United States, japan and South Korea: Are Genetic and Environmetal Variation in Birth weight similar in Caucasians and East Asia? Twin research and Human Genetics 2005; 8(6):638-648.
[24]	Jonnson M. Induction of Twin pregnancy and the risk of caesarean delivery: a cohort study. Jonnson BMC Pregnancy and Chirldbirth 2015 (115); 136.
[25]	Barbara L, Hediger M, Sung-Joon M, Morton BB, Ruta BM, Gonazalez-Quintero VA et al. gender mix in twins and fetal growth, length of gestation and adult cancer risk. Paediatric and perinatal Epidemiology 2005. Blacwell Publishing LTD (19) 41-47.
[26]	Ernesto F, Rafael G, Jose L, Manuel PPH, Jose LB. perinatal mortality in twin pregnancy. J Perinat Med 1988 (16) 85-91.
[27]	Hawrylysbyn PA, Barkin M, Bernstein A, Papsn FR. Twin Pregnancies- A continuing perinatal challenge. Obstet Gynecol 1983 (59)463.
[28]	Bassey G, Inimgba WM. Fetomaternal outcome of twin gestation in Port Harcourt, south-south Nigeria. Niger J Med. 2014 23 (4): 282-7.
[29]	Ibrahim AY, Ayiyuba R. twin birth in Kano, Northern Nigeria. Journ of Pharm. 2013 3 (1):04-08.
[30]	Akaba GO, Agidi TY, Onofowokan O, Offiong RA, Adewole NO. Review of twin pregnancies in a tertiary Hospital in Abuja, Nigeria. J Health Popul Nutr. 2013; 31(2): 272-277.
[31]	Doom ECG, Delbaere I, Martens G, Termarmen G. birth weight for gestational age among Flemish twin population. Issues in obs, gyn and reproductive health. 2012; 4(1): 42-49.
[32]	Nakamuro M, Uzuki Y, Inu T. the effect of birth weight; Does fetal origin really matter for long run outcome. Economics letters. 2013; 121(1): 53-58.
[33]	Isa I, Oyeyemi A, Obilah A. twin pregnancies in the Niger Delta of Nigeria: a four year review. Int. J Women Health. 2012; (4): 245-249.
[34]	Sunday-Adeoye I, Twomey ED, Egwuatu VE. A 20 year review of twin births at Mater Misericordiae Hospital, Afikpo. South Eastern Nigeria. Niger Journ Clinc Pract. 2008; 11(3): 231-234.