The Impact of Twin Birth on Early Neonatal Outcomes

Monica Fumagalli; Paola Schiavolin; Laura Bassi; Michela Groppo; Sara Uccella; Agnese De Carli; Sofia Passera; Ida Sirgiovanni; Francesca Dessimone; Dario Consonni; Barbara Acaia; Luca Antonio Ramenghi; Fabio Mosca

doi:10.1055/s-0035-1556881

American Journal of Perinatology, Table of Contents

Am J Perinatol 2016; 33(01): 063-070
DOI: 10.1055/s-0035-1556881

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Impact of Twin Birth on Early Neonatal Outcomes

Monica Fumagalli

¹NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Università degli Studi di Milano, Milan, Italy

,

Paola Schiavolin

¹NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Università degli Studi di Milano, Milan, Italy

,

Laura Bassi

¹NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Università degli Studi di Milano, Milan, Italy

,

Michela Groppo

¹NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Università degli Studi di Milano, Milan, Italy

,

Sara Uccella

¹NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Università degli Studi di Milano, Milan, Italy

,

Agnese De Carli

¹NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Università degli Studi di Milano, Milan, Italy

,

Sofia Passera

¹NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Università degli Studi di Milano, Milan, Italy

,

Ida Sirgiovanni

¹NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Università degli Studi di Milano, Milan, Italy

,

Francesca Dessimone

¹NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Università degli Studi di Milano, Milan, Italy

,

Dario Consonni

²Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Università degli Studi di Milano, Milan, Italy

,

Barbara Acaia

³Department of Obstetrics and Gynecology Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Milan, Italy

,

Luca Antonio Ramenghi

⁴Neonatal Intensive Care Unit, Istituto Giannina Gaslini Genova, Genoa, Italy

,

Fabio Mosca

¹NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Università degli Studi di Milano, Milan, Italy

› Author Affiliations

Abstract

Objective This study aims to describe the impact of twin birth, chorionicity, intertwin birth weight (BW) discordance and birth order on neonatal outcomes.

Study Design We performed a hospital-based retrospective study on 2,170 twins (6.4% of all live births) and 2,217 singletons inborn 2007 to 2011. Data on neonatal characteristics, morbidities, and mortality were collected and compared. Univariate and multiple (adjusted for gestational age [GA] and gender) linear random intercept regression models were used.

Results Overall, 62.3% of twins were born premature. At multiple regression, twins were similar to singletons for neonatal morbidities, but they were more likely to have lower BW and to be born by cesarean delivery. Monochorionic twins had lower GA and BW compared with dichorionic ones and were more likely to develop respiratory distress syndrome (odds ratio [OR], 1.7), hypoglycemia (OR, 3.3), need for transfusion, (OR, 3.4) but not brain abnormalities. Moderate and severe BW discordance were associated with longer length of stay and increased risk for morbidities but not for death. Birth order had no effects.

Conclusion Prematurity was the most common outcome in twins and accounted for the apparently increased risk in morbidities. Monochorionicity was confirmed as risk factor for lower GA and neonatal morbidities. BW discordance may play a role in developing neonatal complications and needs to be further investigated.

Keywords

twin - birth weight discordance - chorionicity - birth order - neonatal morbidities

Full Text

References

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