title: Outcome of twin pregnancy in women ≥45 years old: a retrospective cohort study.
abstract: OBJECTIVE
  To investigate prematurity rate in women aged ≥45 carrying a twin pregnancy. Other maternal and neonatal outcomes are also described.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Women delivering a twin pregnancy at a single tertiary medical center.
  
  
  METHODS
  The study included all women aged 45 years and over carrying a twin pregnancy who delivered at 20 weeks gestation or beyond over a 9-year period from May 2000 to May 2009.
  
  
  METHODS
  Women aged 45 years and over were identified, all conceived by in vitro fertilization with ovum donation. The study group was compared to a control group of women <40 years with twin pregnancies conceived by IVF who delivered during the same time period.
  
  
  METHODS
  Maternal complications during pregnancy and neonatal outcome.
  
  
  RESULTS
  During the study period 32 women ≥45 years delivered twins. The control group included 109 women. The rate of delivery before 37 weeks as well as before 32 weeks were very high in our study group (65% versus 40%, p = 0.01 and 15% versus 5.0%, p = 0.05, respectively). The rate of maternal life-threatening complications including blood product transfusion and maternal admission to the intensive care unit were also significantly higher in our study group compared to the control group (18% versus 2%, p = 0.018 and 6.3% versus none, p = 0.05).
  
  
  CONCLUSIONS
  Women ≥45 years old with twin pregnancy carry a higher risk of maternal and perinatal complications.
authors.affiliation: Department of Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv University , Tel Aviv , Israel.
authors.forename: I
authors.initials: I
authors.lastname: Laskov
authors.forename: N
authors.initials: N
authors.lastname: Michaan
authors.forename: A
authors.initials: A
authors.lastname: Cohen
authors.forename: Z
authors.initials: Z
authors.lastname: Tsafrir
authors.forename: S
authors.initials: S
authors.lastname: Maslovitz
authors.forename: M
authors.initials: M
authors.lastname: Kupferminc
authors.forename: Jb
authors.initials: J
authors.lastname: Lessing
authors.forename: A
authors.initials: A
authors.lastname: Many
mesh_terms: D005260:Female; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D007557:Israel / Q000453:epidemiology; D008423:Maternal Age; D008875:Middle Aged; D018587:Oocyte Donation; D011247:Pregnancy; D011256:Pregnancy Outcome; D059285:Pregnancy, Twin / Q000706:statistics & numerical data; D047928:Premature Birth / Q000453:epidemiology*; D012189:Retrospective Studies