Reduced lung function during childhood in identical twins with discordant fetal growth: a cohort study

• Published in: EClinicalMedicine 2024-06, Vol.72, p.102600-102600, Article 102600
• Main Authors: Spekman, Jip A., Israëls, Joël, de Vreede, Ilja, Los, Mady, Geelhoed, Miranda J.J., van Zwet, Erik W., Haak, Monique C., Roest, Arno A.W., van Klink, Jeanine M.M., Lopriore, Enrico, Groene, Sophie G.
• Format: Article
• Language: English
• Subjects: Lung function; Monochorionic twins; Selective fetal growth restriction; Spirometry
• ISSN: 2589-5370; 2589-5370
• DOI: 10.1016/j.eclinm.2024.102600

Fetal growth restriction (FGR) can negatively affect lung development, leading to increased respiratory morbidity and reduced lung function later in life. Studies regarding the impact of FGR on lung function in singletons are influenced by genetic, obstetric, and maternal factors. To overcome these confounding factors, we aim to investigate lung function in identical twins with selective FGR (sFGR). Lung function assessments were performed in identical twins with sFGR born in our centre between March 1, 2002, and December 31, 2017, aged between 5 and 17 years. sFGR was defined as birthweight discordance ≥20%. Outcome measures consisted of forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and transfer factor for carbon monoxide (DLCO) and were compared between the smaller and larger twin. Thirty-nine twin pairs performed spirometry of sufficient quality. Median gestational age at birth was 34.3 (interquartile range (IQR) 32.1–36.0) weeks with median birthweights of 1500 (IQR 1160–1880) grams and 2178 (IQR 1675–2720) grams for the smaller and larger twin, respectively. Smaller twins had significantly lower z-scores for FEV1 (−0.94 versus −0.41, p = 0.0015), FVC (−0.56 versus −0.06, p