Russian Journal of Woman and Child Health
ISSN 2618-8430 (Print), 2686-7184 (Online)

Centile nomograms for body weight and length of multiple-birth infants

Open accessCrossrefAntiplagiat


russian citation indexroad




DOI: 10.32364/2618-8430-2020-3-1-20-25

K.R. Bondarenko1, P.A. Kuznetsov1–3, L.S. Dzhokhadze1, V.V. Lyan1, A.V. Kriger1, E.S. Eletnova1

1Pirogov Russian National Research Medical University, Moscow, Russian Federation

2City Clinical Hospital No. 24, Moscow, Russian Federation

3Research Institute of Public Health Organization and Medical Management, Moscow, Russian Federation

Anthropometric screening of body weight and length is one of the first steps of infant’s health assessment. However, nomograms for multiple-birth infants are badly regulated and were not reviewed for a long time.

Aim: to develop body weight and length nomograms for twin infants.

Patients and Methods: the study was performed in three obstetrical inpatient departments located in various Moscow districts. Data on
52 357 infants born in 2015–2017 (50 555 singleton-birth infants and 1802 multiple-birth infants) were analyzed. Study group included 1802 infants (901 twins) born at 22–40 weeks of gestation. These infants were divided into 2 subgroups. Subgroup I included 158 monochorionic twins and subgroup II included 743 dichorionic twins. Control group included 50.555 singleton-birth infants born at 22–42 weeks of gestation.

Results: body weight and length of twin infants are similar to these of singleton-birth infants up to 30 weeks of gestation. After 30 weeks of gestation, this difference progressively increases both in boys and girls. Twin growth discordance (weight difference >20%) is of particular interest. Dissociation of twin development is associated with higher rate of complications. However, it’s only  fair when smaller twin growth is restricted.

Conclusions: anthropometric parameters of multiple-birth and singleton-birth infants are different. Fetal weight less than 10th percentile for a certain term by adjusted nomograms for twins is the criterion for fetal growth restriction. Therefore, nomograms for multiple-birth children should be regulated and approved. Diagnostic criteria for fetal growth restriction in multiple pregnancy should be reviewed according to our nomograms for twins to prevent overdiagnosis of this obstetrical complication.

Keywords: multiple pregnancy, twins, nomograms, dissociation, fetal growth restriction.

For citation: Bondarenko K.R., Kuznetsov P.A., Dzhokhadze L.S. et al. Centile nomograms for body weight and length of multiple-birth infants. Russian Journal of Woman and Child Health. 2020;3(1):–25. DOI: 10.32364/2618-8430-2020-3-1-20-25.

About the authors:

1Karina R. Bondarenko — MD, PhD, Assistant Professor of the Department of Obstetrics and Gynecology, ORCID ID 0000-0003-4147-1151;

1–3Pavel A. Kuznetsov — MD, PhD, Assistant Professor of the Department of Obstetrics and Gynecology, ORCID ID 0000-0003-2492-3910;

1Lela S. Dzhokhadze — MD, PhD, Assistant of the Department of Obstetrics and Gynecology, ORCID ID 0000-0001-5389-7817;

1Victoria V. Lyan — student of the 6th course of Medical Faculty, ORCID ID 0000-0003-4830-6052;

1Anna V. Kriger — student of the 6th course of Medical Faculty, ORCID ID 0000-0001-6823-2658;

1Ekaterina S. Eletnova — student of the 6th course of Medical Faculty, ORCID ID 0000-0002-8857-9779.

1Pirogov Russian National Research Medical University. 1, Ostrovityanov str., Moscow, 117437, Russian Federation.

2City Clinical Hospital No. 24. 4, Vyatskiy Lane, Moscow, 127287, Russian Federation.

3Research Institute of Public Health Organization and Medical Management. 9, Sharikopodshipnikovskaya str., Moscow, 15088, Russian Federation.

Contact information: Karina R. Bondarenko, e-mail: Financial Disclosure: no authors have a financial or property interest in any material or method mentioned. There is no conflict of interests. Received 28.10.2019.

1. The Demographic Yearbook of Russia (Electronic resource). URL: (access date: 24.09.2019) (in Russ.).
2. Kristiansen M.K., Joensen B.S., Ekelund C.K. et al. Perinatal outcome after first-trimester risk assessment in monochorionic and dichorionic twin pregnancies: a population-based register study. BJOG. 2015;122(10):1362–1369. DOI: 10.1111/1471-0528.13326. 3. Prohorova V.S., Pavlova N.G. Perinatal outcomes in multiple pregnancy. Journal of Obstetrics and Women’s Diseases. 2010;3:55-58 (in Russ.). DOI:10.1258/rsmsmj.55.3.58.
4. D’Antonio F., Odibo A., Prefumo F. et al. Weight discordance and perinatal mortality in twin pregnancy: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2018;52(1):11–23. DOI: 10.1002/uog.18966.
5. Sichinava L.G., Panina O.B., Gamsahurdia K.G. Discordant fetal growth in pregnant women with monochorionic twins. Obstetrics, gynecology and reproduction 2015;9(1):6–12 (in Russ.). DOI: 10.17749/2313-7347.2015.9.1.006-012.
6. Ražem K., Bombač L., Tul N. et al. Neonatal morbidity and mortality among growth-discordant dichorionic twins, classified according to birth weight of the smaller twin: a population-based cohort study. J Matern Fetal Neonatal Med. 2018:1–101. DOI: 10.1080/14767058.2018.1555812.
7. Branum A.M., Schoendorf K.C. The effect of birth weight discordance on twin neonatal mortality. Obstet Gynecol. 2003;101:570–574. DOI: 10.1097/00006250-200303000-00025.
8. Blickstein I., Keith L.G. Neonatal mortality rates among growth-discordant twins, classified according to the birth weight of the smaller twin. Am J Obstet Gynecol. 2004;190:170–4. DOI: 10.1016/j.ajog.2003.07.025.
9. Markova T.V., Kosovcova N.V., Chukanova A.N. Selective growth retardation of one fetus from monochorionic twins: modern management methods. Russian Bulletin of the Obstetrician-Gynecologist. 2016;15(3):42–47 (in Russ.). DOI: 10.17116/rosakush201616342-47.
10. Townsend R., Khalil A. Fetal growth restriction in twins. Best Pract Res Clin Obstet Gynaecol. 2018;49:79–88. DOI: 10.1016/j.bpobgyn.2018.02.004.
11. Blickstein I. Normal and abnormal growth in multiple pregnancies. In: Kurjak A., Papp Z., Chervenak F.A. eds. The Fetus as a Patient: The Evolving Challenge. London: Parthenon Publishing;2002.
12. Ghi T., Prefumo F., Fichera A. et al. Società Italiana di Ecografia Ostetrica e Ginecologica Working Group on Fetal Biometric Charts. Development of customized fetal growth charts in twins. Am J Obstet Gynecol. 2017;216(5):514.e1–514.e17. DOI: 10.1016/j.ajog.2016.12.176.
13. Bricelj K., Blickstein I., Bržan-Šimenc G. et al. Growth curves for twins in Slovenia. The Journal of Maternal-Fetal and Neonatal Medicine. 2017;30(4) 6479–481. DOI: 10.1080/14767058.2016.1175425.
14. Nikkels P.G.J., Hack K.E.A., van Gemert M.J.C. Pathology of twin placentas with special attention to monochorionic twin placentas. J Clin Pathol. 2008;61:1247–1253. DOI: 10.1136/jcp.2008.055210.
15. Bang H., Bae G.E., Park H.Y. et al. Chronic Placental Inflammation in Twin Pregnancies. J Pathol Transl Med. 2015;49:489–496. DOI: 10.4132/jptm.2015.09.09.
16. Kosińska M., Sierzputowska-Pieczara M., Gadzinowski J. et al. Percentile charts of twin birthweight. Pediatr Int. 2018;60(10):948–953. DOI: 10.1111/ped.13669.
17. Zhang B., Cao Z., Zhang Y. et al. Birthweight percentiles for twin birth neonates by gestational age in China. Sci Rep. 2016;6:31290. DOI: 10.1038/srep31290.
18. Fridrih V. Twins. M.: Progress; 1985 (in Russ.).
19. Waidl E. Die Merhlingsgeburt. In: H. Schwalm und G. Doderlein. Klinik der Frauenheilkunde und Geburtshilfe. Munchen/Wien; 1977.
20. Zaharova L.I., Pechkurov D.V., Kol’cova N.S. Outpatient neonatology: shaping the health of a child in its first year of life. Pract. guidelines for primary care pediatricians, general practitioners, family doctors. M.: Medpraktika-M; 2014 (in Russ.).
21. Novikova S.V., Civcivadze E.B., Klimova I.V. Anthropometric indicators of newborns with multiple pregnancy at various stages of pregnancy. RMJ. Mother and child. 2014:22 (1):22–24 (in Russ.).
22. Luke B., Hediger M., Min S. et al. Gender mix in twins and fetal growth, length of gestation and adult cancer risk. Paediatr Perinat Epidemiol. 2005;19(1):41–47. DOI: 10.1111/j.1365-3016.2005.00616.x.
23. Goldman R.D., Blumrozen E., Blickstein I. The influence of a male twin on birthweight of its female co-twin — a population-based study. Twin Res. 2003;6(3):173–176. DOI: 10.1375/136905203765693816.

License Creative Commons
This work is licensed under a Creative Commons «Attribution» 4.0 License.
Previous article
Next article

Register now and get access to useful services:
  • Загрузка полнотекстовых версий журналов (PDF)
  • Медицинские калькуляторы
  • Список избранных статей по Вашей специальности
  • Видеоконференции и многое другое

С нами уже 50 000 врачей из различных областей.

Fatal error: Call to undefined function get_registration_form_description_popup() in /home/c/cb72209/wchjournal/public_html/en/include/reg_form.php on line 89