4.2 | Strengths and limitations
The main strengths of the study are, first, to reveal altered neonatal
hair metabolome in response to early intrauterine environment dysbiosis
of DCDA twins with growth discordance. Secondly,
we evidenced that hair metabolic variations in utero may be associated
with poor neurocognitive development of growth discordance in DCDA
twins.
Our findings are subject to the following limitations. Only 14 DCDA-D
twin pairs were included in this study because BW discrepancy increases
the risk of neonatal complications and infant mortality, making it
challenging to follow up both co-twins at 2~3 years old.
A longer follow-up study of larger sample size should be performed to
evaluate the metabolic effects of the intrauterine environment reflected
by using multiple various biospecimens on the later neurobehavioral
development.