Hostname: page-component-78c5997874-94fs2 Total loading time: 0 Render date: 2024-11-10T13:58:18.222Z Has data issue: false hasContentIssue false
  • English
  • Français

Factors Associated with Neonatal Problems in Twin Gestations

Published online by Cambridge University Press:  01 August 2014

D. Fraser ,
R. Picard  and
E. Picard
D. Fraser*
Affiliation:
Epidemiology and Health Services Evaluation Unit, Faculty of Health Sciences, Ben-Gurion University of the Negev, Israel
R. Picard
Affiliation:
Division of Obstetrics and Gynecology, Soroka Medical Center, Beer-Sheva, Israel
E. Picard
Affiliation:
Division of Pediatrics, Soroka Medical Center, Beer-Sheva, Israel
*
Departement of Epidemiology, School of Public Health, University of North Carolina, CB 7400, Mcgavran-Greenberg Hall, Chapel Hill, NC 27599-7400, USA

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

We examined the neonatal outcome of 644 twins weighing 500 g or more and 656 singletons, born in the years 1984-1986 in the Soroka Medical Center, Beer-Sheva, Israel. There was nearly a four-fold risk of antepartum death in twins vs singletons, which disappeared when birth weight was controlled for. The risks for intrapartum and early neonatal mortality were not raised in this population. A statistically significant relative risk for congenital heart malformations in twins vs singletons remained (RR = 5.0, 95% CI = 1.5-16.3), after controlling for maternal age. Significantly higher rates of hyalin membrane disease, hypoglycemia, hyperbilirubinemia, anemia and septicemia were found in twins. Controlling for the confounding of the association between twinning and mortality or morbidity caused by differences in distributions of mode of delivery or gestational age between twins and singletons, was not as efficient as the controlling for birth weight. Thus, adjustment for birth weight removed all the excess risks detected except in hypoglycemia. Our findings suggest that the-lower birth weight of twins, which is so intimately associated with multiple gestations, is probably the single most important factor associated with neonatal problems found in twin births.

Keywords

TwinsMortalityMorbidityCongenital malformationsBirth weight
Type
Research Article
Information
Acta geneticae medicae et gemellologiae: twin research , Volume 40 , Issue 2 , April 1991 , pp. 193 - 200
Copyright
Copyright © The International Society for Twin Studies 1991

References

REFERENCES

1.Behrman, RE, Vaughan, VC (1987): In Cooke, D (ed): Nelson Textbook of Pediatrics, 13th Ed. Philadelpia: Saunders, pp 394–395.Google Scholar
2.Verduzeo, RD, Rosario, R, Rigatto, H (1976): Hyaline membrane disease in twins: A 7 year review with a study on zygosity. Am J Obstet Gynecol 125: 668–671.CrossRefGoogle Scholar
3.Fabre, E, Gonzalez-de-Aguero, R, de Agustin, JL, Perez-Hiraldo, MP, Bescos, JL (1988): Perinatal mortality in twin pregnancy: An analysis of birth weight specific mortality rates and adjusted mortality rates for birth weight distribution. J Perinatol Med 16: 85–91.Google Scholar
4.Ghai, V, Vidyasagar, D (1988): Morbidity and morality factors in twins. An epidemiologic approach. Clin Perinatol 15: 1234–140.CrossRefGoogle Scholar
5.Gluck, L, Kulovich, MV (1973): Lecithin/sphingomyelin ratios in amniotic fluid in normal and abnormal pregnancy. Am J Obstet Gynecol 115: 539–546.CrossRefGoogle ScholarPubMed
6.Ho, SK, Wu, PYK (1975): Perinatal factors and neonatal morbidity in twin pregnancy. Am J Obstet Gynecol 122: 979–987.Google Scholar
7.McCarthy, BJ, Sachs, BP, Layde, P, Burton, A, Terry, J, Rochat, R (1981): The epidemiology of neonatal death in twins. Am J Obstet Gynecol 141: 252–256.CrossRefGoogle ScholarPubMed
8.McCulloch, K (1988): Neonatal problems in twins. Clin Perinatol 15: 141–158.Google Scholar
9.Medearis, AL, Jonas, JS, Stockbaner, JW, Damke, HR (1979): Perinatal deaths in twin pregnancy. A five year analysis of statewide statistics in Missouri. Am J Obstet Gynecol 134: 413–419.Google Scholar
10.Myrianthopoulos, NC, Churchil, JA, Baszynski, AJ (1971): Respiratory distress syndrome in twins. Acta Genet Med Gemellol 20: 199–244.Google Scholar
11.Naeye, RL, Tafari, N, Judge, D, Marboe, C (1978): Twins: Causes of perinatal death in 12 United States cities and one African city. Am J Obstet Gynecol 131: 267–279.CrossRefGoogle ScholarPubMed
12.Newton, ER (1986): Antepartum care in multiple gestation. Semin Perinatol 10: 19–21.Google ScholarPubMed
13.Picard, R, Fraser, D, Hagay, ZJ, Leiberman, JR (1989): Twinning in southern Israel; secular trends, ethnic variation and effects of maternal age and parity. Eur J Obstet Gynecol Reprod Biol 33: 131–139.CrossRefGoogle ScholarPubMed
14.Rothman, KJ (1986): Modern Epidemiology. Boston/Toronto: Little Brown and Co.Google Scholar
15.Thompson, SA, Lyons, TL, Makowski, EL (1987): Outcomes of twin gestation at the University of Colorado Health Sciences Center, 1973-1983. J Reprod Med 32: 328–339.Google Scholar
16.Wenstrom, KD, Gall, SA (1988): Incidence, morbidity and mortality, and diagnosis of twin gestations. Clin Perinatol 15: 1–11.Google Scholar
17.Windham, GC, Bjerkedal, T (1984): Malformation in twins and their siblings, Norway, 1967-1979. Acta Genet Med Gemellol 33: 87–95.Google Scholar