Background Several factors contribute to neurodevelopmental outcomes in preterm infants. The aim of this study was to examine the genetic and environmental influences on long-term outcomes in preterm twins. Methods From a prospective cohort of 225 preterm neonates studied with MRI, 24 monozygotic and 52 dizygotic twins were included. Neurodevelopmental outcomes at 1.5 and 3 years were assessed with the Bayley-III and at 4.5 years with The Movement Assessment Battery for Children and The Wechsler Preschool and Primary Scale of Intelligence-III. Results Preterm monozygotic and dizygotic twin pairs ( N = 76 neonates) had similar neurodevelopmental outcomes at all time points. Monozygotic twins ( N = 24) did not show greater agreement for outcomes relative to dizygotic twins ( N = 52). Twin pairs who were discordant in development ( N = 12) were born at a lower gestational age and had a higher incidence of bronchopulmonary dysplasia and retinopathy of prematurity. Discordant twins become more similar in cognitive and language outcomes over time. Conclusions Neurodevelopmental outcomes in preterm twins may relate more strongly to environmental factors than genetics. Discordant twins were born earlier and had more perinatal morbidities. Despite the initial discordance, these twin pairs become similar in outcomes over time, which may reflect the positive impact of home environment or early intervention programs. Impact Neurodevelopmental outcomes in preterm twins relate more strongly to environmental factors than genetics. Monozygotic twins did not show greater agreement in outcomes relative to dizygotic twins suggesting a stronger environmental, rather than genetic, influence on development. Twin pairs who were discordant in development were born at a lower gestational age and had a higher incidence of perinatal morbidities. Despite the initial discordance, these twin pairs become more similar in cognitive and language outcomes over time, which may reflect the positive impact of early intervention programs or home environment. Neurodevelopmental outcomes in preterm twins are influenced by exposure to early-life insults or environmental stressors. The initial variability in outcomes among preterm infants is not fixed, and efforts made post-discharge from the neonatal intensive care unit can have a substantial impact on long-term outcomes.

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早产双胞胎的纵向神经发育结果

背景 有几个因素会影响早产儿的神经发育结果。本研究的目的是检查遗传和环境对早产双胞胎长期结局的影响。方法 从 225 名使用 MRI 研究的早产新生儿的前瞻性队列中，包括 24 名同卵双胞胎和 52 名双卵双胞胎。使用 Bayley-III 评估 1.5 和 3 年的神经发育结果，使用儿童运动评估电池和韦克斯勒学前和初级智力量表-III 评估 4.5 年的神经发育结果。结果早产单卵双胞胎和双卵双胞胎（N = 76 名新生儿）在所有时间点都有相似的神经发育结果。单卵双胞胎 (N = 24) 相对于双卵双胞胎 (N = 52) 的结果没有表现出更大的一致性。发育不一致的双胞胎（N = 12）出生时胎龄较低，支气管肺发育不良和早产儿视网膜病变的发生率较高。随着时间的推移，不和谐的双胞胎在认知和语言结果上变得更加相似。结论 早产双胞胎的神经发育结果与环境因素的相关性可能比遗传因素更强。不一致的双胞胎出生得更早，并且围产期发病率更高。尽管最初不一致，但随着时间的推移，这对双胞胎的结果变得相似，这可能反映了家庭环境或早期干预计划的积极影响。影响早产双胞胎的神经发育结果与环境因素的关系比遗传因素更强烈。与异卵双胞胎相比，单卵双胞胎的结果没有表现出更大的一致性，这表明环境对发育的影响更大，而不是遗传影响。发育不一致的双胞胎出生时胎龄较低，围产期发病率较高。尽管最初存在不一致，但随着时间的推移，这对双胞胎在认知和语言结果上变得更加相似，这可能反映了早期干预计划或家庭环境的积极影响。早产双胞胎的神经发育结果受到早期生活侮辱或环境压力因素的影响。早产儿结局的初始变异性并不固定，从新生儿重症监护病房出院后所做的努力可能对长期结局产生重大影响。而不是遗传，对发育的影响。发育不一致的双胞胎出生时胎龄较低，围产期发病率较高。尽管最初存在不一致，但随着时间的推移，这对双胞胎在认知和语言结果上变得更加相似，这可能反映了早期干预计划或家庭环境的积极影响。早产双胞胎的神经发育结果受到早期生活侮辱或环境压力因素的影响。早产儿结局的初始变异性并不固定，从新生儿重症监护病房出院后所做的努力可能对长期结局产生重大影响。而不是遗传，对发育的影响。发育不一致的双胞胎出生时胎龄较低，围产期发病率较高。尽管最初存在不一致，但随着时间的推移，这对双胞胎在认知和语言结果上变得更加相似，这可能反映了早期干预计划或家庭环境的积极影响。早产双胞胎的神经发育结果受到早期生活侮辱或环境压力因素的影响。早产儿结局的初始变异性并不固定，从新生儿重症监护病房出院后所做的努力可能对长期结局产生重大影响。发育不一致的双胞胎出生时胎龄较低，围产期发病率较高。尽管最初存在不一致，但随着时间的推移，这对双胞胎在认知和语言结果上变得更加相似，这可能反映了早期干预计划或家庭环境的积极影响。早产双胞胎的神经发育结果受到早期生活侮辱或环境压力因素的影响。早产儿结局的初始变异性并不固定，从新生儿重症监护病房出院后所做的努力可能对长期结局产生重大影响。发育不一致的双胞胎出生时胎龄较低，围产期发病率较高。尽管最初存在不一致，但随着时间的推移，这对双胞胎在认知和语言结果上变得更加相似，这可能反映了早期干预计划或家庭环境的积极影响。早产双胞胎的神经发育结果受到早期生活侮辱或环境压力因素的影响。早产儿结局的初始变异性并不固定，从新生儿重症监护病房出院后所做的努力可能对长期结局产生重大影响。这可能反映了早期干预计划或家庭环境的积极影响。早产双胞胎的神经发育结果受到早期生活侮辱或环境压力因素的影响。早产儿结局的初始变异性并不固定，从新生儿重症监护病房出院后所做的努力可能对长期结局产生重大影响。这可能反映了早期干预计划或家庭环境的积极影响。早产双胞胎的神经发育结果受到早期生活侮辱或环境压力因素的影响。早产儿结局的初始变异性并不固定，从新生儿重症监护病房出院后所做的努力可能对长期结局产生重大影响。