Strengths and Limitations
To the best of our knowledge, few systematic reviews explored the
association between GHD and birthweight discordance in twin pregnancies.
The main strengths are an inclusive and accurate literature search
strategy, multitude of explored outcomes, sub-group analyses performed
according to the classification of GHD and stratified sampling conducted
based on twin chorionicity.
However, some limitations needed to be acknowledged were small number of
selected studies, different inclusion criteria for the included
population, and different approach towards the antenatal management of
twin pregnancies. The reliability of the systematic review was strongly
limited by the small sample size of individual studies. Furthermore, the
findings were subject to the differences
in the cut‐off of birthweight
discordance adopted by each study. Another major limitation of our
present systematic review was that as only one of the included
studies21 reported twin pregnancies with eclampsia,
lack of related data made it a challenge to report the association
between the incidence of eclampsia and the risk of intertwin birthweight
discordance.
In spite of these limitations, this study represents the newest and most
comprehensive published assessment of the association between GHD and
birthweight discordance in twin pregnancies.