Cardiac findings in newborn twins

Aims: To evaluate cardiac findings in newborn twins from the general population and investigate if newborn twins may require systematic evaluation of cardiac parameters. Methods: Prospective cohort study of newborns with cardiac evaluation performed during the first month of life. Cardiac findings were compared 1:3 with matched singletons. Results: We included 412 newborn twins (16% monochorionic; 50% boys) and 1236 singletons. Comparing cardiac findings showed twins had an increased prevalence of non-severe structural heart disease (most common: ventricular septal defects in both groups), thinner left ventricular posterior wall in diastole (LVPWd; 1.82 vs. 1.87 mm, p = 0.02), smaller diameter of the left atrium (10.6 vs. 11.1 mm, p = 0.04), higher heart rate (148 vs. 144 bpm, p = 0.04), more left-shifted QRS axis (106 vs. 111 degrees, p < 0.001), and lower maximum R-wave amplitude in V1 (927 vs. 1015 mu V, p = 0.02) compared to singletons. After multifactorial adjustment for potential confounders, the effect of twinning on cardiac parameters persisted only for LVPWd (p < 0.05). Conclusion: Despite contemporary surveillance, we found an increased prevalence of non-severe structural heart disease in a population-based cohort of newborn twins. However, the effect of twinning on cardiac parameters was modest and generally did not persist after correction for likely confounding factors.

Automated summary

This study aimed to evaluate the cardiac findings in newborn twins from the general population and investigate whether systematic evaluation of cardiac parameters is necessary for newborn twins. The results showed that compared to singletons, twins had a higher prevalence of non-severe structural heart disease, such as ventricular septal defects, and some differences in cardiac parameters. However, after considering potential confounding factors, the effect of twinning on cardiac parameters was relatively small.