Am J Perinatol 2010; 27(7): 537-542
DOI: 10.1055/s-0030-1248940
© Thieme Medical Publishers

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

Jerrie S. Refuerzo1 , Valerija Momirova2 , Alan M. Peaceman3 , Anthony Sciscione4 , Dwight J. Rouse5 , Steve N. Caritis6 , Catherine Y. Spong7 , Michael W. Varner8 , Fergal D. Malone9 , Jay D. Iams10 , Brian M. Mercer11 , John M. Thorp12 , Yoram Sorokin13 , Marshall W. Carpenter14 , Julie Lo15 , Margaret Harper16 for the Eunice Kennedy Shriver National Institute of Child Health Human Development Maternal-Fetal Medicine Units Network
  • 1Department of Obstetrics and Gynecology at the University of Texas Health Science Center at Houston, Houston, Texas
  • 2Northwestern University, Chicago, Illinois
  • 3Drexel University, Philadelphia, Pennsylvania
  • 4University of Alabama at Birmingham, Birmingham, Alabama
  • 5University of Pittsburgh, Pittsburgh, Pennsylvania
  • 6University of Utah, Salt Lake City, Utah
  • 7Columbia University, New York, New York
  • 8The Ohio State University, Columbus, Ohio
  • 9Case Western Reserve University, Cleveland, Ohio
  • 10University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
  • 11Wayne State University, Detroit, Michigan
  • 12University of Texas Southwestern Medical Center, Dallas, Texas
  • 13Brown University, Providence, Rhode Island
  • 14Wake Forest University Health Sciences, Winston-Salem, North Carolina
  • 15The George Washington University Biostatistics Center, Washington, D.C.
  • 16the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
Further Information

Publication History

Publication Date:
19 February 2010 (online)

ABSTRACT

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 320/7 and 336/7 weeks and LPTB between 340/7 and 366/7 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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Jerrie RefuerzoM.D. 

Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Texas Health Science Center at Houston 6431 Fannin Street

#3.270 Houston, TX 77030

Email: Jerrie.S.Refuerzo@uth.tmc.edu