Specialized prenatal care and maternal and infant outcomes in twin pregnancy.
OBJECTIVE
This study was undertaken to evaluate the effect of a prenatal nutrition and education program on twin pregnancy, neonatal, and early childhood outcomes.


METHODS
This prospective intervention study of women who participated in a specialized program (Program Pregnancies) versus nonparticipants included twice-monthly visits, dietary prescription of 3000 to 4000 kcal per day, multimineral supplementation, and patient education.


RESULTS
Program Pregnancies were associated with improved pregnancy outcomes (preeclampsia, adjusted odds ratio [AOR] 0.41, 95% CI, 0.23-0.75; preterm premature rupture of membranes, AOR 0.35, 95% CI, 0.20-0.60; delivery <36 weeks, AOR 0.62, 95% CI, 0.43-0.89; low birth weight, AOR 0.42, 95% CI, 0.29-0.61), significantly longer gestations (+7.6 days), higher birth weights (+220 g), lower neonatal morbidity (retinopathy of prematurity, necrotizing enterocolitis, intraventricular hemorrhage, or ventilator support, AOR 0.44, 95% CI, 0.31-0.62), length of stay (-5.3 days), and cost per twin (-14,023 dollars). Through 3 years of age, program children were significantly less likely to be rehospitalized (AOR 0.31, 95% CI, 0.11-0.91) or to be developmentally delayed (AOR 0.65, 95% CI, 0.44-0.96).


CONCLUSIONS
Program participation was associated with improved outcomes at birth and through age 3 years.
Department of Epidemiology and Public Health, University of Miami School of Medicine, Fla., USA.
Barbara
B
Luke
Morton B
MB
Brown
Ruta
R
Misiunas
Elaine
E
Anderson
Clark
C
Nugent
Cosmas
C
van de Ven
Barbara
B
Burpee
Shirley
S
Gogliotti
D000328:Adult; D001724:Birth Weight; D002675:Child, Preschool; D005260:Female; D006128:Growth; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D052756:Nutritional Sciences / Q000193:education; D007752:Obstetric Labor, Premature; D016017:Odds Ratio; D010353:Patient Education as Topic; D011247:Pregnancy; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple; D011295:Prenatal Care / Q000592:standards*; D011446:Prospective Studies; D012307:Risk Factors; D014427:Twins