The pregnancy and long-term neurodevelopmental outcome of monochorionic diamniotic twin gestations: a multicenter prospective cohort study from the first trimester onward

Am J Obstet Gynecol. 2009 May;200(5):494.e1-8. doi: 10.1016/j.ajog.2009.01.048.


Objectives: We sought to document the pregnancy and neurodevelopmental outcome in monochorionic diamniotic twin pregnancies and to identify risk factors for death and impairment.

Study design: We conducted a prospective cohort study of 136 monochorionic twins followed up from the first trimester until infancy.

Results: A total of 122 (90%) pregnancies resulted in 2 survivors, 6 (4%) in 1 survivor and 8 (6%) in no survivor. In all, 230 (92%) of 250 surviving infants were assessed at a mean age of 24 months. Neurodevelopmental impairment was present in 22 (10%) infants. Death or impairment of 1 or both infants occurred in 28 (22%) of 126 pregnancies. Twin-to-twin transfusion syndrome and assisted conception increased the risk of both death and impairment, whereas early-onset discordant growth only increased the risk of death.

Conclusion: The mortality in this prospective series was 8% and neurodevelopmental impairment occurred in 10% of infants.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Amnion
  • Cerebral Palsy / epidemiology
  • Chorion
  • Developmental Disabilities / epidemiology*
  • Female
  • Fetal Death / epidemiology*
  • Fetofetal Transfusion / mortality*
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Pregnancy
  • Pregnancy Outcome / epidemiology*
  • Pregnancy Trimester, First
  • Prospective Studies
  • Risk Factors
  • Twins*