ArticleFrontiers in pediatrics2026
Feeding challenges in larger versus smaller preterm discordant twins.
Article in Frontiers in pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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4 authors.
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Abstract
Background: This single-center retrospective cohort study aims to compare the risk of necrotizing enterocolitis (NEC) and feed intolerance between the larger and the smaller preterm twin in dichorionic (DC) and monochorionic (MC) twins with birth weight discordance (BWD). Methods: All consecutive live-born twin pairs born in the Nanjing Drum Tower Hospital between 1 January 2023, and 31 July 2025, were reviewed. BWD was defined as more than 20% difference in intertwin birth weight. Neonatal outcomes were compared between the larger and the smaller twin within each twin pair. Data on the start time of enteral feeding, time to attain full enteral feeds (FEF), delayed attainment of FEF, number of fasting episodes, maximum physiological weight loss, time to regain birth weight, the average weight growth velocity, and the frequency of breastfeeding were collected. Results: We included 30 DC twins and 35 MC twins. The smaller twin had a higher frequency of NEC than the larger twin in both the DC group (23.33% vs Conclusions: In preterm twins with BWD, the smaller twin has an increased risk of NEC compared with the larger one, which may be attributed to the small twin being SGA. Therefore, the smaller twin needs close observation and monitoring in the early phase after birth because these preterm infants are at increased risk for feeding intolerance.
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