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.