A Matched Cohort Comparison of the Outcome of Twin Versus Singleton Pregnancies in Flanders, Belgium

Jacquemyn, Yves; Martens, Guy; Ruyssinck, Gunther; Michiels, Ian; Overmeire, Bart Van

doi:10.1375/136905203762687834

Cited by 37 publications

(32 citation statements)

References 10 publications

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“…In the present study, the risk of low birth weight was nearly 20% higher in twins than in single pregnancies. Prematurity and low birth weight are associated with a higher risk of perinatal death . Gestational age at birth did not show any significant difference in the current analysis; however, twin pregnancy is known to be associated with higher rates of preterm birth before 34 weeks when compared to single pregnancies (42.3% and 36.7%, respectively).…”

Section: Discussioncontrasting

confidence: 66%

“…Higher rates of admission to the NICU and a 5‐minute Apgar score less than 7 in twin pregnancies have also been described in the literature. However, in the present study only admission to the NICU was associated with twin PTB . Some neonatal complications are directly related to prematurity, including feeding difficulties, infection, respiratory distress syndrome, jaundice, cerebral hemorrhage, necrotizing enterocolitis, retinopathy, and anemia.…”

Section: Discussioncontrasting

confidence: 58%

See 1 more Smart Citation

Maternal and perinatal outcomes and factors associated with twin pregnancies among preterm births: Evidence from the Brazilian Multicenter Study on Preterm Birth (EMIP)

Santana

Cecatti

Surita

et al. 2020

Intl J Gynecology & Obste

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Objective: To compare maternal and perinatal outcomes between twin and single preterm births (PTB) and associated factors. Methods:A cross-sectional multicenter study was conducted in Brazil with 4046 PTBs from April 2011 to July 2012. Causes of PTB, use of tocolytics, corticosteroids, and antibiotics in twin and single pregnancies, and factors possibly associated with twinning were evaluated using χ 2 tests. Maternal and perinatal outcomes were assessed with prevalence ratios (PR). Results:The main cause of PTB in twin pregnancy was spontaneous onset of preterm labor. Tocolytics were more frequently used in twins (26.9% vs 20.2%). Factors associated with PTB in twins were: maternal age >25 years (62.3% vs 53.4%); interpregnancy interval >3 years (39.0% vs 33.4%); no history of PTB (87.4% vs 79.6%); no previous maternal conditions (78.0% vs 73.3%); no alcohol abuse (88.5% vs 84.3%); no drug addiction (97.5% vs 94.5%); and >6 prenatal visits (46.5% vs 37.6%). Twin pregnancies run a 46% higher risk of cesarean delivery, while first and second twins face a 20% higher risk of low birth weight. Twin pregnancies run increased risks for admission to the NICU, cerebral hemorrhage, necrotizing enterocolitis, and any adverse perinatal outcome. Conclusion:Preterm twin birth is associated with low birth weight and worse neonatal outcomes. K E Y W O R D S

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Section: Discussioncontrasting

confidence: 66%

Section: Discussioncontrasting

confidence: 58%

Maternal and perinatal outcomes and factors associated with twin pregnancies among preterm births: Evidence from the Brazilian Multicenter Study on Preterm Birth (EMIP)

Santana

Cecatti

Surita

et al. 2020

Intl J Gynecology & Obste

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“…Many of these studies were of smaller cohorts, included infants of higher gestation, and some were uncontrolled for potential confounders. [16][17][18][19][20][21][22]29 Large cohort studies of neonatal networks from United States (1991States ( -1994, Israel (1995Israel ( -1999, and Europe (2003) have reported similar risks of mortality when comparing extremely preterm singletons and twins, 8,21,24 although these studies are of earlier time periods. Two other cohort studies from Canada and Australia of more recent time periods have reported significantly higher AORs of mortality in extremely preterm multiples compared with singletons.…”

Section: Discussionmentioning

confidence: 99%

“…13, [16][17][18][19][20][21] Several studies have also highlighted the effect of birth weight as a potential confounder in assessing the risk of mortality in multiples. 16,22,23 Additionally, there has been a smaller number of reports with some conflicting results on the effects of plurality on the risk of major morbidities such as bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP), severe intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), and necrotizing enterocolitis (NEC) in extremely preterm infants.…”

Section: Admission Of Multiple Gestation Infants (Multiples) To Nicus Inmentioning

confidence: 99%

Trends in Morbidity and Mortality of Extremely Preterm Multiple Gestation Newborns

et al. 2015

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To examine the risk of mortality and major morbidities in extremely preterm multiple gestation infants compared with singletons over time.METHODS: This is a retrospective study of 15 402 infants born #27 weeks' gestation, admitted to NICUs in the Australian and New Zealand Neonatal Network from 1995 to 2009. Mortality and major morbidities were compared between singletons and multiples across three 5-year epochs.RESULTS: Extreme preterm multiples were more likely to have lower birth weight; higher maternal age; and higher rates of assisted conception, antenatal steroid use, and cesarean delivery compared with singletons. The mortality rate was significantly higher in multiples compared with singletons even as there was a trend of decreasing gestational-age stratified mortality in multiples over the time period investigated. The rates of major morbidities or composite adverse outcomes were not different between multiples and singletons across all epochs. The adjusted odds ratio (AOR) for mortality in multiples was significantly higher in multiples compared with singletons (AOR 1.20, 95% confidence interval [CI] 1.08-1.34). There were no differences in the adjusted odds for poor outcomes in multiples compared with singletons in the most recent epoch: mortality (AOR 1.00, 95% CI 0.84-1.19), major morbidity (0.95, 95% CI 0.81-1.10), and composite adverse outcome (0.96, 95% CI 0.83-1.11).CONCLUSIONS: Over the 15-year period, the odds for mortality in extremely preterm NICU infants of multiple gestation was significantly higher compared with singletons. The adjusted odds of poor outcomes in multiples were not significantly different from that of singletons in the most recent epoch. WHAT'S KNOWN ON THIS SUBJECT:Studies on the risk of mortality and morbidities of extremely preterm infants of multiple gestation births have shown inconsistent results. Perinatal antecedents, admission status and severity of illness after birth can adversely affect outcomes of the extremely premature infants.WHAT THIS STUDY ADDS: Preterm multiple gestation infants have increased risk of mortality but similar risk of major morbidities compared with singletons. Outcomes improved over time and all adverse outcomes, including mortality, were comparable between multiples and singletons in the most recent 5-year epoch.

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“…It is known that, at the same gestational age, the prognosis for twins is better than singletons, and the current study confirmed those results. 22 These results suggest that when preterm labor is suspected or diagnosed or when the time of preterm delivery must be determined for any reason in the mother or fetus in Korea, it is desirable for the best prognosis of the neonate to maintain pregnancy actively until 35 weeks' gestation for singletons and 33 weeks' gestation for twins.…”

Section: Discussionmentioning

confidence: 99%

Optimal gestational age of delivery to decrease neonatal morbidity in preterm pregnancies in Korea

Park

Jang

et al. 2011

J of Obstet and Gynaecol

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A Matched Cohort Comparison of the Outcome of Twin Versus Singleton Pregnancies in Flanders, Belgium

Cited by 37 publications

References 10 publications

Maternal and perinatal outcomes and factors associated with twin pregnancies among preterm births: Evidence from the Brazilian Multicenter Study on Preterm Birth (EMIP)

Maternal and perinatal outcomes and factors associated with twin pregnancies among preterm births: Evidence from the Brazilian Multicenter Study on Preterm Birth (EMIP)

Trends in Morbidity and Mortality of Extremely Preterm Multiple Gestation Newborns

Optimal gestational age of delivery to decrease neonatal morbidity in preterm pregnancies in Korea

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