Download PDF
Am J Perinatol 2023; 40(02): 206-213
DOI: 10.1055/s-0041-1727227
Original Article

Prior Term Birth Decreases the Risk of Preterm Birth in a Subsequent Twin Gestation

Clara Ward
1   Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center, Houston, Texas
,
Sanae Nakagawa
2   Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, California
,
Yvonne W. Cheng
3   Department of Obstetrics, Gynecology, and Reproductive Sciences, California Pacific Medical Center, San Francisco, California
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Abstract

Objective The aim of the study is to examine the association between the risk of preterm delivery among women with twin pregnancies and their obstetric history.

Study Design We designed a retrospective cohort study of live twin births in 2008 in the United States that delivered after 240/7 weeks. Women were categorized into nulliparas, multiparas with prior term delivery, and multiparas with prior preterm delivery. The incidence of preterm birth was compared using Chi-square test and multivariable logistic regression models.

Results A total of 32,895 nulliparous and 64,701 multiparous women with twin pregnancies were included in the study. Of the multiparous women, 2,505 (4%) had a history of a prior preterm delivery. Multiparous women with prior term birth were more likely to deliver at term (43%) in the index twin pregnancy than nulliparous women (40%) and multiparous women with a prior preterm birth (21%; p < 0.001). Compared with nulliparous women, prior term birth was protective against preterm delivery (adjusted odds ratio [aOR] = 0.67 [95% confidence interval: 0.60–0.74] for delivery <28 weeks and aOR = 0.79 [0.71–0.77] for delivery <34 weeks).

Conclusion Among multiparous women with twins, a prior term delivery appeared to be protective against preterm delivery compared with nulliparous women with twins.

Key Points

  • Prior term birth is protective against preterm birth in subsequent twin pregnancy.

  • A prior term birth confers an OR of 0.66 for delivery prior to 28 weeks in twin pregnancies.

  • A prior preterm birth renders a twin pregnancy nearly twice as likely to deliver before 28 weeks.

Keywords

multiparas - multiple gestation - preterm birth - risk factors - twins

Note

Multiparas with a prior term birth have decreased risk of preterm delivery in twin pregnancies compared to nulliparas and women with a prior preterm delivery.




Publication History

Received: 20 September 2020

Accepted: 02 March 2021

Article published online:
04 May 2021

© 2021. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Esplin MS, O'Brien E, Fraser A. et al. Estimating recurrence of spontaneous preterm delivery. Obstet Gynecol 2008; 112 (03) 516-523
    CrossrefPubMedGoogle Scholar
  • 2 Bloom SL, Yost NP, McIntire DD, Leveno KJ. Recurrence of preterm birth in singleton and twin pregnancies. Obstet Gynecol 2001; 98 (03) 379-385
    PubMedGoogle Scholar
  • 3 Mercer BM, Goldenberg RL, Moawad AH. et al; National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. The preterm prediction study: effect of gestational age and cause of preterm birth on subsequent obstetric outcome. Am J Obstet Gynecol 1999; 181 (5 Pt 1): 1216-1221
    CrossrefPubMedGoogle Scholar
  • 4 Lykke JA, Paidas MJ, Langhoff-Roos J. Recurring complications in second pregnancy. Obstet Gynecol 2009; 113 (06) 1217-1224
    CrossrefPubMedGoogle Scholar
  • 5 Yamashita M, Hayashi S, Endo M. et al; Obstetric Research Collaborative in Osaka (ORCO). Incidence and risk factors for recurrent spontaneous preterm birth: a retrospective cohort study in Japan. J Obstet Gynaecol Res 2015; 41 (11) 1708-1714
    CrossrefPubMedGoogle Scholar
  • 6 Goldenberg RL, Iams JD, Miodovnik M. et al; National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. The preterm prediction study: risk factors in twin gestations. Am J Obstet Gynecol 1996; 175 (4 Pt 1): 1047-1053
    CrossrefPubMedGoogle Scholar
  • 7 Guzman ER, Walters C, O'reilly-Green C. et al. Use of cervical ultrasonography in prediction of spontaneous preterm birth in twin gestations. Am J Obstet Gynecol 2000; 183 (05) 1103-1107
    CrossrefPubMedGoogle Scholar
  • 8 Durnwald CP, Momirova V, Rouse DJ. et al; Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Second trimester cervical length and risk of preterm birth in women with twin gestations treated with 17-α hydroxyprogesterone caproate. J Matern Fetal Neonatal Med 2010; 23 (12) 1360-1364
    CrossrefPubMedGoogle Scholar
  • 9 Shapiro-Mendoza CK, Barfield WD, Henderson Z. et al. CDC grand rounds: public health strategies to prevent preterm birth. MMWR Morb Mortal Wkly Rep 2016; 65 (32) 826-830
    CrossrefPubMedGoogle Scholar
  • 10 Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Mathews TJ, Osterman MJ. Births: final data for 2008. Natl Vital Stat Rep 2010; 59 (01) 1-3 –71
    PubMedGoogle Scholar
  • 11 Stock S, Norman J. Preterm and term labour in multiple pregnancies. Semin Fetal Neonatal Med 2010; 15 (06) 336-341
    CrossrefPubMedGoogle Scholar
  • 12 Murray SR, Stock SJ, Cowan S, Cooper ES, Norman JE. Spontaneous preterm birth prevention in multiple pregnancy. Obstet Gynaecol 2018; 20 (01) 57-63
    CrossrefPubMedGoogle Scholar
  • 13 Berghella V, Dugoff L, Ludmir J. Prevention of preterm birth with pessary in twins (PoPPT): a randomized controlled trial. Ultrasound Obstet Gynecol 2017; 49 (05) 567-572
    CrossrefPubMedGoogle Scholar
  • 14 Hester AE, Ankumah NE, Chauhan SP, Blackwell SC, Sibai BM. Twin transvaginal cervical length at 16-20 weeks and prediction of preterm birth. J Matern Fetal Neonatal Med 2019; 32 (04) 550-554
    CrossrefPubMedGoogle Scholar
  • 15 Han MN, O'Donnell BE, Maykin MM, Gonzalez JM, Tabsh K, Gaw SL. The impact of cerclage in twin pregnancies on preterm birth rate before 32 weeks. J Matern Fetal Neonatal Med 2019; 32 (13) 2143-2151
    CrossrefPubMedGoogle Scholar
  • 16 Michaluk A, Dionne MD, Gazdovich S, Buch D, Ducruet T, Leduc L. Predicting preterm birth in twin pregnancy: was the previous birth preterm? A Canadian experience. J Obstet Gynaecol Can 2013; 35 (09) 793-801
    CrossrefPubMedGoogle Scholar
  • 17 Easter SR, Little SE, Robinson JN, Mendez-Figueroa H, Chauhan SP. Obstetric history and likelihood of preterm birth of twins. Am J Perinatol 2018; 35 (11) 1023-1030
    Article in Thieme ConnectPubMedGoogle Scholar
  • 18 Purisch SE, Turitz AL, Elovitz MA, Levine LD. The effect of prior term birth on risk of recurrent spontaneous preterm birth. Am J Perinatol 2018; 35 (04) 380-384
    Article in Thieme ConnectPubMedGoogle Scholar
  • 19 Frey HA, McLaughlin EM, Hade EM. et al. Obstetric history and risk of short cervix in women with a prior preterm birth. Am J Perinatol 2020; 39 (07) 759-765
    PubMedGoogle Scholar
  • 20 Yang J, Baer RJ, Berghella V. et al. Recurrence of preterm birth and early term birth. Obstet Gynecol 2016; 128 (02) 364-372
    CrossrefPubMedGoogle Scholar
  • 21 User Guide to the 2008 Natality Public Use File. Center for Disease Control and Prevention. Accessed July 10, 2010 at: http://www.cdc.gov/nchs/nvss.htm
    PubMedGoogle Scholar
  • 22 Ananth CV. Menstrual versus clinical estimate of gestational age dating in the United States: temporal trends and variability in indices of perinatal outcomes. Paediatr Perinat Epidemiol 2007; 21 (Suppl. 02) 22-30
    CrossrefPubMedGoogle Scholar
  • 23 Wier ML, Pearl M, Kharrazi M. Gestational age estimation on United States livebirth certificates: a historical overview. Paediatr Perinat Epidemiol 2007; 21 (Suppl. 02) 4-12
    CrossrefPubMedGoogle Scholar
  • 24 Defranco EA, Chang JJ, Macones GA, Muglia LJ. The correlation in birth timing between singleton and twin gestations in the same mother. J Matern Fetal Neonatal Med 2009; 22 (02) 106-110
    CrossrefPubMedGoogle Scholar
  • 25 Tarter JG, Khoury A, Barton JR, Jacques DL, Sibai BM. Demographic and obstetric factors influencing pregnancy outcome in twin gestations. Am J Obstet Gynecol 2002; 186 (05) 910-912
    CrossrefPubMedGoogle Scholar
  • 26 Kazemier BM, Buijs PE, Mignini L, Limpens J, de Groot CJM, Mol BWJ. EBM CONNECT. Impact of obstetric history on the risk of spontaneous preterm birth in singleton and multiple pregnancies: a systematic review. BJOG 2014; 121 (10) 1197-1208 , discussion 1209
    CrossrefPubMedGoogle Scholar
  • 27 Facco FL, Nash K, Grobman WA. Are women who have had a preterm singleton delivery at increased risk of preterm birth in a subsequent twin pregnancy?. Am J Perinatol 2008; 25 (10) 657-659
    Article in Thieme ConnectPubMedGoogle Scholar
  • 28 Ananth CV, Kirby RS, Vintzileos AM. Recurrence of preterm birth in twin pregnancies in the presence of a prior singleton preterm birth. J Matern Fetal Neonatal Med 2008; 21 (05) 289-295
    CrossrefPubMedGoogle Scholar
  • 29 Hannoun A, Usta IM, Awwad J. et al. Effect of parity on maternal and neonatal outcomes in twin gestations. Acta Obstet Gynecol Scand 2012; 91 (01) 117-121
    CrossrefPubMedGoogle Scholar