EATG » Does maternal HCV infection affect twin birth weight discordance?

Does maternal HCV infection affect twin birth weight discordance?

Twins born to mothers with hepatitis C virus (HCV) infection had a significantly higher risk for developing inter-twin birth weight discordance compared with twins born to mothers without HCV infection, according to study results published in PLoS One.1

Approximately 16% of twin pregnancies have a birth weight discordance of at least 20% and twins with discordant growth are at increased risk for perinatal morbidity and mortality.1,2 Studies have identified a number of risk factors for inter-twin birth weight discordance;3-13 however, none have examined the effect of maternal HCV infection. Therefore, researchers used birth records for 270,256 pairs of twins (or 540,512 individual records) from the 2011 to 2015 United States birth records census created by the Centers for Disease Control and Prevention to analyze the association between HCV infection in pregnancy and inter-twin birth weight discordance.1 They found that of these twin pairs, 850 (0.31%) mothers had HCV infection and these twins tended to have a higher rate of birth weight discordance compared with mothers without HCV infection, although this was not statistically significant. However, after adjusting for potential confounding factors, including maternal demographic factors, HCV infection became a significant risk factor for birth weight discordance (all P values <0.05).

The study authors concluded that, “HCV infection in pregnancy represents a non-negligible health problem for unborn fetus, and our study adds to the literature by highlighting its potential impact on inter-twin birth weight discordance, an important adverse outcome to be prevented in twin pregnancies.”1 They added, “we advocate a universal screening rather than risk-based screening for HCV in women of childbearing age.”

By Virginia Schad

References

  1. Xiao Y, Shen M, Ma S, Wen SW, Tan H. The association between inter-twin birth weight discordance and hepatitis C: The United States 2011–2015 twin birth registration dataPLoS One. 2019;14(1):e0211683.
  2. Miller J, Chauhan SP, Abuhamad AZ. Discordant twins: diagnosis, evaluation and managementAm J Obstet Gynecol. 2012;206(1):10-20.
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  8. Lewi L, Gucciardo L, Huber A, et al. Clinical outcome and placental characteristics of monochorionicdiamniotic twin pairs with early- and late-onset discordant growthAm J Obstet Gynecol. 2008;199(5):511.e1-e7.
  9. Sannoh S, Demissie K, Balasubramanian B, Rhoads GG. Risk factors for intrapair birth weight discordance in twinsJ Matern Fetal Neonatal Med. 2003;13(4):230-236.
  10. Tan H, Wen SW, Fung Kee Fung K, Walker M, Demissie K. The distribution of intra-twin birth weight discordance and its association with total twin birth weight, gestational age, and neonatal mortalityEur J Obstet Gynecol Reprod Biol. 2005;121(1):27-33.
  11. Tobe RG, Mori R, Shinozuka N, Kubo T, Itabashi K. Birthweight discordance, risk factors and its impact on perinatal mortality among Japanese twins: data from a national project during 2001–2005Twin Res Hum Genet. 2010;13(5):490-494.
  12. Wen SW, Tan H, Yang Q, Walker M. Prediction of intra-twin birth weight discordance by binary logistic regression analysis. Gynecol Obstet Invest. 2006;62(4):186-192.13.
  13. Lazzarotto T, Gabrielli L, Foschini MP, Lanari M, Guerra B, Eusebi V et al. Congenital cytomegalovirus infection in twin pregnancies: viral load in the amniotic fluid and pregnancy outcomePediatrics. 2003;112(2):e153-e157.