AUTHOR=Wang Xueju , Li Luyao , Yuan Pengbo , Zhao Yangyu , Wei Yuan 

TITLE=Thick artery–artery anastomoses delay the onset of selective fetal growth restriction in monochorionic diamniotic twins: a 7-year single-center cohort study

JOURNAL=Frontiers in Medicine

VOLUME=10

YEAR=2023

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1265875

DOI=10.3389/fmed.2023.1265875

ISSN=2296-858X

ABSTRACT=<sec><title>Objective</title><p>This study aimed to investigate differences in placental characteristics between early- and late-onset selective fetal growth restriction (sFGR) in monochorionic diamniotic twins.</p></sec><sec><title>Methods</title><p>A total of 253 patients with sFGR between April 2013 and April 2020 were retrospectively analyzed. Placental characteristics of early- and late-onset sFGR were compared.</p></sec><sec><title>Results</title><p>The gestational age at diagnosis and delivery in the early-onset group was significantly less than that in the late-onset group [22.0 (16.9–23.9) and 28.4 (24.0, 36.3) weeks, <italic>P</italic> &lt; 0.001; 33.1 ± 2.2 and 33.7 ± 2.5 weeks, <italic>P</italic> = 0.025]. The birth weight of normal growth and growth-restricted fetuses in the early-onset group was less than the late-onset group [1,990 ± 422 and 2,162 ± 525 g, <italic>P</italic> = 0.044; 1,320 ± 409 and 1,595 ± 519 g, <italic>P</italic> = 0.001]. The birthweight discordance ratio in the early-onset group was greater than the late-onset group (0.34 ± 0.12 and 0.29 ± 0.13, <italic>P</italic> = 0.001). The early-onset group had a significantly lower prevalence of sFGR type I than the late-onset group (37.5 and 62.0%, <italic>P</italic> = 0.018). The early-onset group had a significantly higher prevalence of sFGR type III than the late-onset group (30.4 and 12.7%, <italic>P</italic> = 0.048). The early-onset group had a lower prevalence of thick artery–artery anastomoses than the late-onset group (37.5 and 62.0%, <italic>P</italic> = 0.006). The placental territory discordance ratio in the early-onset group was higher than in the late-onset group [0.60 (0.01, 0.80) and 0.50 (0.01, 0.88), <italic>P</italic> = 0.018].</p></sec><sec><title>Conclusion</title><p>Unequal placental territory is the cause for most of the late-onset sFGR. Thick artery–artery anastomoses may delay the onset time of these cases of sFGR.</p></sec>