AUTHOR=Fontana Camilla , Schiavolin Paola , Ardemani Giulia , Amerotti Danila Angela , Pesenti Nicola , Bonfanti Chiara , Boggini Tiziana , Gangi Silvana , Porro Matteo , Squarza Chiara , Giannì Maria Lorella , Persico Nicola , Mosca Fabio , Fumagalli Monica 

TITLE=To be born twin: effects on long-term neurodevelopment of very preterm infants—a cohort study

JOURNAL=Frontiers in Pediatrics

VOLUME=Volume 11 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2023.1217650

DOI=10.3389/fped.2023.1217650

ISSN=2296-2360

ABSTRACT=Objective: To examine the effect of twin birth on long-term neurodevelopmental outcomes in an Italian children cohort of very low birth weight preterm infants. 
Study design: We performed a retrospective cohort study on children born in a tertiary care center.  We included children born between 01/01/2007 and 31/12/2013 with GA <=32 weeks and BW<1500 g. Infants born from twin pregnancies complicated by twin-to-twin transfusion syndrome and from higher-order multiple pregnancies were excluded. Children were evaluated both at 2 years corrected age and 5 years chronological age with Griffiths Mental Development Scales Revised (GMDS-R). Linear mixed effects models were used to study the effect of being a twin versus being a singleton on GMDS-R scores, adjusting for GA, being born SGA, sex, length of NICU stay, socio-economic status and comorbidity score (CS) calculated as the sum of the weights associated with each of the infants’ major morbidities. 
Results: 301 children were included in the study, of which 189 (62.8%) were singletons and 112 (37.2%) were twins; 23 out of 112 twins were monochorionic (MC). No statistically significant differences were observed between twins and singletons in terms of mean General Quotient and subscales at both 2 and 5 years. No effect of chorionicity was found when comparing scores of MC and dichorionic twins versus singletons; however, after adjusting for CS, MC twins showed lower scores in the hearing and language and performance subscales at 5 years.
Conclusion: Overall, in our cohort of children born very preterm, twin infants were not at higher risk of neurodevelopmental impairment compared with singletons at pre-school age.