Are women who have had a preterm singleton delivery at increased risk of preterm birth in a subsequent twin pregnancy?
Our objective was to determine whether preterm birth of a singleton is associated with an increased risk of preterm birth of twins in a subsequent pregnancy. We identified all women who delivered a singleton followed by twins at Northwestern Memorial Hospital during a 10-year period. Using a cohort study design, we compared women with preterm singleton deliveries to women with term singleton deliveries with regard to their subsequent twin pregnancy outcomes. Two hundred ninety-three were identified who delivered a singleton followed by twins. Women who delivered a preterm singleton were significantly more likely to deliver subsequent preterm twins (73.9% versus 44.4%, odds ratio 3.5, 95% confidence interval 1.4 to 9.3). This significant difference persisted in multivariable analysis after controlling for ethnicity (adjusted odds ratio 3.3, 95% confidence interval 1.3 to 8.7). We concluded that preterm birth of a singleton is associated with an increased risk of preterm delivery in a subsequent twin gestation.
Department of Obstetrics and Gynecology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA. f-facco@md.northwestern.edu
Francesca L
FL
Facco
Kate
K
Nash
William A
WA
Grobman
D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D015999:Multivariate Analysis; D011247:Pregnancy; D011272:Pregnancy, Multiple; D047928:Premature Birth; D018570:Risk Assessment; D014427:Twins