Document Detail


Differences in short-term neonatal outcomes between discordant twins.
MedLine Citation:
PMID:  19060578     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate short-term outcomes associated with discordant twin pairs admitted to the NICU. DESIGN: A retrospective descriptive study comparing discordant twin pairs. SUBJECTS: Three hundred eighty-four discordant twin pairs were included. Mean gestational age of the twin pairs was 32.6 weeks (range, 24-39). METHODS: The ParadigmHealth database was queried for all twin admissions from January 2001 to June 2004 admitted to 453 NICUs across the United States. Discordance was calculated for each twin set as defined as greater than 20% difference in birth weight. Exclusion criteria were death of a twin, congenital anomalies, or extracorporeal life support. MAIN OUTCOME MEASURES: Demographics, respiratory needs, feeding characteristics, complications, and discharge needs. RESULTS: A total of 384 discordant twin pairs met inclusion criteria. The larger twins required more ventilation/continuous positive airway pressure (55% vs 44%, P < .01) and/or oxygen therapy (50% vs 41%, P = .02) compared with smaller twins. Smaller twins reached full oral (PO) feeds an average of 0.6 weeks later than larger twins (P < .0001) but had more weight gain per day. Smaller twins transitioned to an open crib at lower weights but at slightly greater age. No differences were noted with necrotizing enterocolitis or apnea. Smaller twins had increased nosocomial infections. Mean length of stay was shorter (P = .0036) in the larger twin group. Only 33% of the twin pairs were discharged on the same day. CONCLUSIONS: Larger twins had more acute respiratory issues but achieved certain milestones more rapidly with fewer complications, thus leading to earlier discharge compared with their smaller twin counterparts.
Authors:
Ursula S Nawab; Jay S Greenspan; Sharon Kirkby; Jennifer F Culhane; Michael Kornhauser
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Publication Detail:
Type:  Comparative Study; Journal Article; Twin Study    
Journal Detail:
Title:  Advances in neonatal care : official journal of the National Association of Neonatal Nurses     Volume:  8     ISSN:  1536-0903     ISO Abbreviation:  Adv Neonatal Care     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-12-17     Completed Date:  2009-03-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101125644     Medline TA:  Adv Neonatal Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  334-42     Citation Subset:  IM    
Affiliation:
Thomas Jefferson University/duPont Hospital for Children, Philadelphia, Pennsylvania, USA.
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MeSH Terms
Descriptor/Qualifier:
Chi-Square Distribution
Diseases in Twins / nursing*
Female
Gestational Age
Humans
Infant, Newborn
Infant, Newborn, Diseases / nursing*
Intensive Care Units, Neonatal
Male
Retrospective Studies
Treatment Outcome

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


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