Neonatal outcome of very premature infants from multiple and singleton gestations.
OBJECTIVE
Our purpose was to determine whether, in the era of surfactant treatment, very premature neonates from multiple gestations have outcomes similar to those of singletons.


METHODS
We collected data on 572 infants (369 singletons, 203 multiple gestation) born and cared for at a single institution from July 1, 1992, through Dec, 31, 1994, of gestational ages 24 to 32 weeks. We compared singleton infants with infants from multiple gestations within gestational age categories 24 to 26 weeks, 27 to 29 weeks, and 30 to 32 weeks.


RESULTS
Infants of multiple gestations were more likely to have been born by cesarean section. The incidences of respiratory distress syndrome and bronchopulmonary dysplasia were similar, except that respiratory distress syndrome was more frequent in infants of multiple gestations at 30 to 32 weeks. Infants of multiple gestations from 27 to 29 weeks were more likely to have at least one of the following complications: patent ductus arteriosus, intraventricular hemorrhage, necrotizing enterocolitis, or retinopathy of prematurity. Further analysis suggested that this increase is unlikely to cause a difference in long-term outcome. The survival to discharge increased from 79% (multiples) and 81% (singletons) at 24 to 26 weeks to 98% (multiples) and 96% (singletons) at 30 to 32 weeks.


CONCLUSIONS
Incidences of significant neonatal problems in very premature infants from multiple gestations who are born alive are little different from those of singletons. These data should have an impact on decision making in the perinatal and neonatal care of infants of multiple gestations.
Nielsen
H C
HC
Department of Pediatrics, Floating Hospital for Infants and Children, New England Medical Center, Boston, MA, USA.
Harvey-Wilkes
K
K
MacKinnon
B
B
Hung
S
S
D001724:Birth Weight / Q000502:physiology; D001997:Bronchopulmonary Dysplasia / Q000453:epidemiology / Q000503:physiopathology; D002543:Cerebral Hemorrhage / Q000453:epidemiology / Q000503:physiopathology; D002585:Cesarean Section; D004374:Ductus Arteriosus, Patent / Q000453:epidemiology / Q000503:physiopathology; D004761:Enterocolitis, Pseudomembranous / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007224:Infant Care; D007230:Infant, Low Birth Weight / Q000502:physiology; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D011247:Pregnancy / Q000502:physiology*; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple / Q000502:physiology*; D012127:Respiratory Distress Syndrome, Newborn / Q000453:epidemiology / Q000503:physiopathology; D012178:Retinopathy of Prematurity / Q000453:epidemiology / Q000503:physiopathology; D012189:Retrospective Studies