Differences in outcome between twins and singletons born very preterm: Result s from a population-based European cohort

Emile Papiernik, Jennifer Zeitlin, Dominique Delmas, Béatrice Blondel, Wolfgang Künzel, Marina Cuttini, Tom Weber, Stavros Petrou, Ludwig Gortner, Louis Kollée, Elizabeth S. Draper

Research output: Contribution to journalArticle

Abstract

Background About 10 of twins are born before 32 weeks of gestation and very preterm birth rates are increasing. Preterm twins tend to have more favourable outcomes than singletons of the same gestational age, but fewer data are available for very preterm infants. This study aims to determine whether outcomes differ between very preterm twins and singletons.Method This study was of a population-based cohort of very preterm babies in 10 European regions in 2003. Mortality and morbidity to discharge from hospital were compared for twins and singletons between 24 and 31 weeks of gestation, who were alive at the onset of labour and without lethal congenital anomalies. Clinical characteristics, pregnancy complications and healthcare factors were taken into consideration.Result SBetween 28 and 31 weeks of gestation, mortality and oxygen dependency at 36 corrected weeks of gestation were lower for twins than singletons (3.9 versus 6.5 and 7.1 versus 10.4, respectively), but this advantage disappeared after controlling for medical and healthcare factors. Hypertension, growth restriction and haemorrhaging were less frequent complications of twin birth and more twins received antenatal corticosteroids and were born in level III units. In contrast, between 24 and 27 weeks of gestation, twins had higher adjusted risks of mortality and Grade III/IV intraventricular haemorrhaging [adjusted ORs 1.5 (95 CI 1.1-2.2) and 1.5 (1.0-2.1)]. These adverse outcomes were concentrated among twins from same sex pairs with discordant birthweights.Conclusion SBetween 24 and 27 weeks of gestation, risks of mortality and severe cranial haemorrhaging were higher for twins than singletons if they were from same sex pairs with discordant birthweights.

Original languageEnglish
Pages (from-to)1035-1043
Number of pages9
JournalHuman Reproduction
Volume25
Issue number4
DOIs
Publication statusPublished - Apr 2010

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Population
Pregnancy
Mortality
Labor Onset
Delivery of Health Care
Pregnancy Complications
Birth Rate
Premature Birth
Premature Infants
Gestational Age
Adrenal Cortex Hormones
Parturition
Oxygen
Hypertension
Morbidity
Growth

Keywords

  • Bronchopulmonary dysplasia
  • Intraventricular haemorrhaging
  • Mortality
  • Twins
  • Very preterm infants

ASJC Scopus subject areas

  • Rehabilitation
  • Obstetrics and Gynaecology
  • Reproductive Medicine

Cite this

Differences in outcome between twins and singletons born very preterm : Result s from a population-based European cohort. / Papiernik, Emile; Zeitlin, Jennifer; Delmas, Dominique; Blondel, Béatrice; Künzel, Wolfgang; Cuttini, Marina; Weber, Tom; Petrou, Stavros; Gortner, Ludwig; Kollée, Louis; Draper, Elizabeth S.

In: Human Reproduction, Vol. 25, No. 4, 04.2010, p. 1035-1043.

Research output: Contribution to journalArticle

Papiernik, E, Zeitlin, J, Delmas, D, Blondel, B, Künzel, W, Cuttini, M, Weber, T, Petrou, S, Gortner, L, Kollée, L & Draper, ES 2010, 'Differences in outcome between twins and singletons born very preterm: Result s from a population-based European cohort', Human Reproduction, vol. 25, no. 4, pp. 1035-1043. https://doi.org/10.1093/humrep/dep430
Papiernik, Emile ; Zeitlin, Jennifer ; Delmas, Dominique ; Blondel, Béatrice ; Künzel, Wolfgang ; Cuttini, Marina ; Weber, Tom ; Petrou, Stavros ; Gortner, Ludwig ; Kollée, Louis ; Draper, Elizabeth S. / Differences in outcome between twins and singletons born very preterm : Result s from a population-based European cohort. In: Human Reproduction. 2010 ; Vol. 25, No. 4. pp. 1035-1043.
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AU - Delmas, Dominique

AU - Blondel, Béatrice

AU - Künzel, Wolfgang

AU - Cuttini, Marina

AU - Weber, Tom

AU - Petrou, Stavros

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AB - Background About 10 of twins are born before 32 weeks of gestation and very preterm birth rates are increasing. Preterm twins tend to have more favourable outcomes than singletons of the same gestational age, but fewer data are available for very preterm infants. This study aims to determine whether outcomes differ between very preterm twins and singletons.Method This study was of a population-based cohort of very preterm babies in 10 European regions in 2003. Mortality and morbidity to discharge from hospital were compared for twins and singletons between 24 and 31 weeks of gestation, who were alive at the onset of labour and without lethal congenital anomalies. Clinical characteristics, pregnancy complications and healthcare factors were taken into consideration.Result SBetween 28 and 31 weeks of gestation, mortality and oxygen dependency at 36 corrected weeks of gestation were lower for twins than singletons (3.9 versus 6.5 and 7.1 versus 10.4, respectively), but this advantage disappeared after controlling for medical and healthcare factors. Hypertension, growth restriction and haemorrhaging were less frequent complications of twin birth and more twins received antenatal corticosteroids and were born in level III units. In contrast, between 24 and 27 weeks of gestation, twins had higher adjusted risks of mortality and Grade III/IV intraventricular haemorrhaging [adjusted ORs 1.5 (95 CI 1.1-2.2) and 1.5 (1.0-2.1)]. These adverse outcomes were concentrated among twins from same sex pairs with discordant birthweights.Conclusion SBetween 24 and 27 weeks of gestation, risks of mortality and severe cranial haemorrhaging were higher for twins than singletons if they were from same sex pairs with discordant birthweights.

KW - Bronchopulmonary dysplasia

KW - Intraventricular haemorrhaging

KW - Mortality

KW - Twins

KW - Very preterm infants

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