4.2 Article Proceedings Paper

Neonatal Outcomes in Twin Pregnancies Delivered Moderately Preterm, Late Preterm, and Term

Journal

AMERICAN JOURNAL OF PERINATOLOGY
Volume 27, Issue 7, Pages 537-542

Publisher

THIEME MEDICAL PUBL INC
DOI: 10.1055/s-0030-1248940

Keywords

Twin pregnancy; late preterm birth; neonatal morbidities

Funding

  1. NCATS NIH HHS [UL1 TR000005] Funding Source: Medline
  2. NICHD NIH HHS [U10 HD034116-13, U10 HD027860, HD40500, U10 HD034208, HD34208, HD27915, UG1 HD040500, U10 HD034208-12, R24 HD050924, U10 HD040512, U10 HD027860-15, HD27917, U10 HD021410, U10 HD036801, U10 HD034136-10, U10 HD040545, HD40544, U01 HD036801, U10 HD040544-11, HD34136, HD27869, U10 HD040560, U10 HD027869-10, UG1 HD040545, U10 HD027915, U10 HD027915-19, HD34116, U10 HD027917, U10 HD027869, HD21410, U10 HD027917-18, U10 HD040545-11, HD40560, U10 HD040485-11, U10 HD034116, HD40545, UG1 HD040512, UG1 HD034208, UG1 HD040544, HD40512, U10 HD021410-22, UG1 HD040560, U10 HD040544, UG1 HD027869, HD27860, UG1 HD027915, U10 HD040500-08, U10 HD040485, HD36801, HD40485, U10 HD034136, U10 HD036801-11, U10 HD040512-11, U10 HD040560-11, U10 HD040500, UG1 HD034116, UG1 HD040485] Funding Source: Medline

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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

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