Document Detail


Changes in stillbirth and infant mortality associated with increases in preterm birth among twins.
MedLine Citation:
PMID:  11694681     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To examine whether the recent substantial increase in preterm birth among twins has been associated with changes in fetal and infant mortality. DESIGN: Cohort study based on information in the linked live birth, stillbirth, and mortality databases of Statistics Canada. SETTING: Ten of 12 provinces and territories in Canada. PARTICIPANTS: All twin live births and stillbirths between 1985 and 1996, along with information on deaths during infancy (1985-1997). MAIN OUTCOME MEASURE: Fetal and infant mortality rates. RESULTS: The rate of preterm birth among twin live births increased significantly by 17% (95% confidence interval: 14%-20%) from 42.5% between 1985 and 1987 to 49.6% between 1994 and 1996. Overall, stillbirth rates among twins declined from 22.4 per 1000 total births in 1985 to 1987 to 18.8 per 1000 total births in 1994 to 1996. Among twin fetuses >/=34 weeks' gestation, stillbirth rates decreased from 9.5 per 1000 in 1985 to 1987 to 5.4 per 1000 fetuses at risk in 1994 to 1996. Infant mortality rates among twin live births declined substantially in all categories of gestational age above 24 weeks except for live births at 32 to 33 and 34 to 36 weeks' gestation. CONCLUSIONS: The recent increase in preterm birth among twins was associated with a substantial reduction in stillbirth rates at and near term gestation. Infant mortality rates declined concurrently, although the absence of a significant decrease in infant mortality among twin live births at 32 to 33 and 34 to 36 weeks' gestational age needs additional scrutiny.
Authors:
K S Joseph; S Marcoux; A Ohlsson; S Liu; A C Allen; M S Kramer; S W Wen;
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Twin Study    
Journal Detail:
Title:  Pediatrics     Volume:  108     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2001 Nov 
Date Detail:
Created Date:  2001-11-05     Completed Date:  2001-12-14     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1055-61     Citation Subset:  AIM; IM    
Affiliation:
Perinatal Epidemiology Research Unit, Departments of Obstetrics and Gynecology and Pediatrics, Dalhousie University, Halifax, Nova Scotia. ks.joseph@np.iwkgrace.ns.ca
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MeSH Terms
Descriptor/Qualifier:
Canada / epidemiology
Cohort Studies
Confidence Intervals
Female
Fetal Death / epidemiology*
Humans
Infant Mortality / trends*
Infant, Low Birth Weight*
Infant, Newborn
Infant, Premature*
Obstetric Labor, Premature / epidemiology
Pregnancy

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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