Groeidiagrammen voor lengte, gewicht en 'body mass index' van tweelingen in de peutertijd

Abstract

Objective. To determine the magnitude of the growth retardation in Dutch monozygotic and dizygotic twins during infancy in comparison with the Dutch reference growth charts for general population infants from 1997 and to construct reference growth charts for twins. Design. Descriptive. Method. The growth of twins was studied using longitudinal data on over 4000 Dutch twin pairs from birth until 2.5 years of age. The LMS method was used to obtain growth charts for height, weight and body-mass index (BMI) for twin pairs during infancy. Centiles were estimated by the Box-Cox power curve (L), the median curve (M) and the coefficient of variation curve (S). Results. From birth until the age of half a year, the average height and weight of twin pairs were at about the 10th percentile of the Dutch reference population. One year later this difference had decreased to about the 25th percentile, and when the twin pairs were between 1.5 and 2.5 years of age the difference was further decreased to the 35th percentile. The BMI deviated less from that of the reference population: during the first half a year the BMI of twin pairs was at about the 25th percentile. Subsequently, the BMI improved, but remained slightly below the median of the reference population at the age of about two years. Approximately half (50% for height, 58% for weight) of the growth retardation from birth until 1.5 years was attributable to gestational age. Between 1.5 years and 2.5 years of age, this difference was reduced to one third: 33% for both height and weight. Thus, a substantial part of the growth difference could not be explained by gestational age. Conclusion. Correcting for gestational age alone is not sufficient to make possible a comparison of the growth of twin pairs with the growth of general population infants. The development of twins can, however, be followed by means of the reference growth charts designed by the authors.