title: Prematurity and twinning.
abstract: OBJECTIVE
  Newborns from multiple pregnancies are increasing in number and demonstrate a higher perinatal morbidity and mortality compared to singletons. Prematurity is the main reason for most neonatal diseases in twins, but other variables may play a role and their prenatal evaluation may improve the overall outcome.
  
  
  RESULTS
  Prematurity is six times more frequent in twins and therefore birth weight is significantly lower compared to singletons. Thus, twins are more exposed to prematurity related diseases (respiratory, cardiovascular, infectious, etc.) and to long-term complications (especially neurological disabilities).
  
  
  RESULTS
  It is very difficult to estimate the increased risk of neonatal morbidity related to twinning independently to the increased risk of prematurity and therefore to interpret data on morbidity rates, in particular regarding the neurodevelopmental outcome.
  
  
  CONCLUSIONS
  Prevention of preterm birth is a primary goal in managing multiple pregnancies, together with prophylaxis with corticosteroids in order to improve foetal lung maturity. Accurate risk assessment strategies and adequate obstetrical-neonatological management of multiple pregnancies may reduce the increasing need for neonatal intensive care and for health resources in the long-term follow-up that has been observed over the last decades.
authors.affiliation: Maternal-Infant, Andrology and Urology Department, University of Palermo, Palermo, Italy. mario.giuffre@unipa.it
authors.forename: Mario
authors.initials: M
authors.lastname: Giuffrè
authors.forename: Ettore
authors.initials: E
authors.lastname: Piro
authors.forename: Giovanni
authors.initials: G
authors.lastname: Corsello
mesh_terms: D004992:Ethics, Medical; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D009420:Nervous System / Q000254:growth & development; D011247:Pregnancy; D011272:Pregnancy, Multiple; D047928:Premature Birth / Q000453:epidemiology* / Q000503:physiopathology; D014427:Twins / Q000706:statistics & numerical data*