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Developmental outcome in a group of twins: Relation to perinatal factors and general movements
Authors:Tamara Dostanic  Breda Sustersic  Darja Paro-Panjan
Institution:1. Department of Neonatology, Division of Paediatrics, University Medical Centre Ljubljana, Bohoriceva 20, 1000, Ljubljana, Slovenia;2. Developmental Clinic, Health Centre Domzale, Mestni Trg 2, 1230, Domzale, Slovenia
Abstract:

Background

The quality of general movements (GMs) has proven to have predictive value for the developmental outcome, but this has not yet been studied in twins.

Aims

Our aim was to analyse the quality of GMs and neurological and developmental outcome in relation to the gestational age (GA), mode of conception and other perinatal risk factors in a group of twins.

Study design

The documentation of twins referred for follow-up in the period from 1998 to 2016 was studied retrospectively. Data concerning the quality of GMs, perinatal risk factors and developmental outcome were analysed.

Subjects

Eighty-nine twin pairs, GA from 24 to 38 weeks (median 35.0; IQR 3), birth weight 670 g–3820 g (median 2323; IQR 645) were included.

Outcome measures

Results of neurological, psychological and speech/language development and school outcome were analysed.

Results

GMs at term age and at three to four months postterm age did not differ with regard to the mode of conception. Preterm birth was significantly related to GMs at three to four months postterm age. At term age, GMs were significantly related to neurological outcome, while at three to four months postterm age, GMs were related to both the neurological and psychological outcome. Difficulties in speech/language development were diagnosed in almost half of the children, more frequently in boys and children with lower Apgar scores.

Conclusion

The study highlights the value of GMs for predicting the developmental outcome in twins and indicates the importance of developmental, especially speech/language, follow-up in twins.
Keywords:Twins  Newborn  Preterm  General movements  Development  GMs  general movements  GA  gestational age  IQR  interquartile range  ART  assisted reproductive technology  CP  cerebral palsy  DD  dichorionic diamniotic  MD  monochorionic diamniotic  MM  monochorionic monoamniotic  SGA  small for gestational age  N  normal  PR  poor repertoire  CS  cramped synchronized  Ch  chaotic  F + NOR  normal fidgety with normal other repertoire  F + AOR  normal fidgety with abnormal other repertoire  AF  abnormal fidgety movements  F  absence of fidgety movements  MND  minor neurological dysfunction  WPPSI-III  Wechsler Preschool and Primary Scale of Intelligence – Third edition  WISC III  Wechsler Intelligence Scales for Children – Third Edition  ABAS-II  The Adaptive Behaviour Assessment System – Second Edition  VMI  Developmental Test of Visual-Motor Integration  BSID II  Bayley Scales of Infant Development - Second Edition  CBCL  Child Behaviour Check list
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