ArticleBJOG : an international journal of obstetrics and gynaecology2025
Predicting Adverse Perinatal Outcomes in Dichorionic Twin Pregnancies: A Multicentre Cohort Study.
Article in BJOG : an international journal of obstetrics and gynaecology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Comprehensive Evaluation of Language, Speech, and Communication Skills in 24- to 36-Month-Old Twins and Singletons: Developmental Differences and Associated Factors.Brain and behavior · 2026Article
- Risk of Placental Pathology Across Ultrasound-Defined Phenotypes of Impaired Fetal Growth in Dichorionic Twins: A Retrospective Cohort Study.BJOG : an international journal of obstetrics and gynaecology · 2026Article
- Early postnatal risk stratification for severe adverse outcomes in twin neonates admitted to the neonatal intensive care unit: development and temporal validation of an interpretable machine learning model.Translational pediatrics · 2026Article
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveDichorionic twin pregnancies are associated with increased risks of stillbirth or medically indicated early preterm birth (ePTB) to avoid stillbirths. This study evaluated the predictive value of fetal estimated weight (EFW) and Doppler indices before adverse perinatal outcomes.
designRetrospective multicentre cohort study.
settingThree tertiary centres in the UK, Italy and Belgium. POPULATION: The study included 1294 dichorionic twin pregnancies managed between 2013 and 2023.
methodsUnivariable and multivariable analyses assessed the association and the predictive accuracy between EFW and Doppler indices taken within 2 weeks of birth or adverse perinatal outcomes.
main outcome measuresStillbirths (of one or both twins) or medically indicated ePTB before 34 weeks' gestation for fetal indications.
resultsThe study identified 58 pregnancies (4.5%) complicated by adverse perinatal outcomes. There were significant differences (all p < 0.001) between twins with adverse perinatal outcomes and liveborn twins for small for gestational age foetuses (89.5% vs. 59.3%), EFW discordance (31.8% vs. 8.4%), umbilical artery (UA) pulsatility index (PI) discordance (39.7% vs. 12.6%) and middle cerebral artery PI discordance (27.6% vs. 13.3%). These associations remained significant after adjusting for maternal characteristics and gestational age. The best predictive model included EFW discordance and UA PI discordance, with an area under the curve of 0.90.
conclusionsThe integration of intertwin EFW and UA PI discordance can effectively predict stillbirths or the need for medically indicated ePTB. After external validation in larger populations, this model could provide effective risk stratification of dichorionic pregnancies to enable targeted interventions to improve clinical outcomes.
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