Neonatal outcomes in twin pregnancies delivered moderately preterm, late preterm, and term.
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.
Refuerzo
Jerrie S
JS
Department of Obstetrics and Gynecology at University of Texas Health Science Center at Houston, Houston, Texas 77030, USA. Jerrie.S.Refuerzo@uth.tmc.edu
Momirova
Valerija
V
Peaceman
Alan M
AM
Sciscione
Anthony
A
Rouse
Dwight J
DJ
Caritis
Steve N
SN
Spong
Catherine Y
CY
Varner
Michael W
MW
Malone
Fergal D
FD
Iams
Jay D
JD
Mercer
Brian M
BM
Thorp
John M
JM
Sorokin
Yoram
Y
Carpenter
Marshall W
MW
Lo
Julie
J
Harper
Margaret
M
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