Is prevention of preterm births in twin pregnancies possible? Analysis of the results of a prevention program in France (1989-1991).
OBJECTIVE
A policy aimed at the prevention of early preterm births in twin pregnancies has been evaluated. The prevention program included: early diagnosis of twinning, information of the mothers about the risk of prematurity, attempts to restrain physical activity and early work leave prescription when indicated.


METHODS
Cohort study of all twin births in a given geographical area (Hauts-de-Seine district); 546 mothers with pregnancy duration of > or = 26 weeks were included; 1088 newborns were followed up to the 28th day of life.


RESULTS
The recommended prevention program is largely used (88% of early diagnosis of twinning, 62% of the women informed and 73% of prescription for reduced physical activity). The very preterm (26-28 weeks) and early preterm (< or = 32 weeks) birth rates are low: 1.5 and 8.5%, respectively. The stillbirth rate is 11 per thousand and the neonatal mortality rate (0-27 days) is 10 per thousand live births, with a persistent difference between the first and the second twin.


CONCLUSIONS
The present study demonstrates the open access and acceptability of the prevention policy; in addition, the perinatal outcomes are better than those of comparable published cohorts.
Tafforeau
J
J
Service d'Epidémiologie, Institut d'Hygiène et d'Epidémiologie, Brussels, Belgium.
Papiernik
E
E
Richard
A
A
Pons
J C
JC
D015331:Cohort Studies; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007752:Obstetric Labor, Premature / Q000453:epidemiology / Q000517:prevention & control*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple; D011295:Prenatal Care; D015397:Program Evaluation; D012307:Risk Factors; D014427:Twins