title: Neonatal outcomes in twin pregnancies delivered moderately preterm, late preterm, and term.
abstract: We compared neonatal outcomes in twin pregnancies following moderately preterm birth (MPTB), late preterm birth (LPTB), and term birth. A secondary analysis of a multicenter, randomized controlled trial of multiple gestations was conducted. MPTB was defined as delivery between 32 (0)/(7) and 33 (6)/(7) weeks and LPTB between 34 (0)/(7) and 36 (6)/(7) weeks. Primary outcome was a neonatal outcome composite consisting of one or more of the following: neonatal death, respiratory distress syndrome, early onset culture-proven sepsis, stage 2 or 3 necrotizing enterocolitis, bronchopulmonary dysplasia, grade 3 or 4 intraventricular hemorrhage, periventricular leukomalacia, pneumonia, or severe retinopathy of prematurity. Among 552 twin pregnancies, the MPTB rate was 14.5%, LPTB 49.8%, and term birth rate 35.7%. The rate of the primary outcome was different between groups: 30.0% for MPTB, 12.8% for LPTB, 0.5% for term birth ( P < 0.001). Compared with term neonates, the primary neonatal outcome composite was increased following MPTB (relative risk [RR] 58.5; 95% confidence interval [CI] 11.3 to 1693.0) and LPTB (RR 24.9; 95% CI 4.8 to 732.2). Twin pregnancies born moderately and late preterm encounter higher rates of neonatal morbidities compared with twins born at term.
authors.affiliation: Department of Obstetrics and Gynecology at University of Texas Health Science Center at Houston, Houston, Texas 77030, USA. Jerrie.S.Refuerzo@uth.tmc.edu
authors.forename: Jerrie S
authors.initials: JS
authors.lastname: Refuerzo
authors.forename: Valerija
authors.initials: V
authors.lastname: Momirova
authors.forename: Alan M
authors.initials: AM
authors.lastname: Peaceman
authors.forename: Anthony
authors.initials: A
authors.lastname: Sciscione
authors.forename: Dwight J
authors.initials: DJ
authors.lastname: Rouse
authors.forename: Steve N
authors.initials: SN
authors.lastname: Caritis
authors.forename: Catherine Y
authors.initials: CY
authors.lastname: Spong
authors.forename: Michael W
authors.initials: MW
authors.lastname: Varner
authors.forename: Fergal D
authors.initials: FD
authors.lastname: Malone
authors.forename: Jay D
authors.initials: JD
authors.lastname: Iams
authors.forename: Brian M
authors.initials: BM
authors.lastname: Mercer
authors.forename: John M
authors.initials: JM
authors.lastname: Thorp
authors.forename: Yoram
authors.initials: Y
authors.lastname: Sorokin
authors.forename: Marshall W
authors.initials: MW
authors.lastname: Carpenter
authors.forename: Julie
authors.initials: J
authors.lastname: Lo
authors.forename: Margaret
authors.initials: M
authors.lastname: Harper
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data; D015986:Confounding Factors, Epidemiologic; D005260:Female; D005322:Premature Rupture of Fetal Membranes; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology; D010298:Parity; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011272:Pregnancy, Multiple / Q000706:statistics & numerical data*; D047928:Premature Birth; D012127:Respiratory Distress Syndrome, Newborn / Q000453:epidemiology; D018805:Sepsis / Q000453:epidemiology; D047929:Term Birth; D014427:Twins; D055815:Young Adult