Prevalence of Cerebral Palsy in Twins, Triplets and Quadruplets

Outcomes, both short and long term, differ between singletons and multiplets. Recently, a number of large, well-designed studies have clarified these differences, particularly in light of major changes in perinatal and neonatal care that have influenced changing outcomes. Accordingly, this article will review risks for singletons, twins and higher-order multiples as whole groups and also after correction for gestational age and other potential confounding variables that differ markedly between the groups. In addition, we will focus on the effects of certain factors such as antenatal steroid therapy and gender. Finally, we will detail the specific long-term risks for multiples in terms of growth and neurodevelopmental disabilities.

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“…With respect to GA, Yokoyama et al [53] found that CP among multiples was 20 times higher in those born at ! 32 weeks than at 36 weeks and above.…”

Section: Birth Weight and Gestational Agementioning

confidence: 99%

Outcomes of Multiplets

2008

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“…1,2 Evidence suggests that ART results in a greater risk of cerebral palsy and chromosome abnormalities, which has been attributed primarily to multiple pregnancy. [3][4][5] Whether the method of assisted reproduction itself affects neurological development of children remains controversial. Previous studies showed that the perinatal outcome of twins conceived by ART was comparable to that of spontaneously conceived twins, when matched for birth weight and gestational age.…”

Section: Introductionmentioning

confidence: 99%

Developmental outcome of very low birth weight twins conceived by assisted reproduction techniques

et al. 2005

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Objective: To evaluate the differences in developmental outcomes between very low birth weight twins conceived by assisted reproduction techniques and those conceived spontaneously.Study design: Twenty-two sets of very low birth weight twins were evaluated by the Kyoto Scale for Psychological Development at 36 months of corrected age. Total developmental quotient and developmental quotient (DQ) for three subscales, posture-motor, cognition-adaptation and language-social, were evaluated.Results: Twins conceived with medical assistance demonstrated a higher incidence of total DQ below 85 with lower DQ for cognition-adaptation and language-social skills than spontaneously conceived twins, whereas the quotient for posture-motor skills in medically assisted twins was comparable to that of spontaneously conceived twins.Conclusion: At 3 years of age very low birth weight twins conceived by assisted reproduction techniques demonstrated lower cognitive and language skills than twins conceived naturally.

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“…The prevalence of cerebral palsy ranges from 7-12 per 1000 infant survivors in twins compared with 1-2 in singletons. [1][2][3][4][5] The higher relative risk of cerebral palsy for twins is not entirely attributable to the overrepresentation of low birthweight and preterm infants, as the risk is also higher for normal birthweight twins than for comparable singletons. 2 5 6 Case reports and hospital based case series have found that the antenatal death of a twin is associated with severe morbidity in the co-twin.…”

mentioning

confidence: 99%