Document Detail


Fetal or infant death in twin pregnancy: neurodevelopmental consequence for the survivor.
MedLine Citation:
PMID:  11815541     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To determine the neurodevelopmental morbidity in the surviving twin after fetal or infant death of the co-twin. METHODS: Twin pregnancies with an antepartum or infant death delivered between 1981 and 1992 were identified from the Northern Perinatal Mortality Survey. Information on the neurodevelopmental morbidity of infant survivors of a deceased co-twin was obtained by a questionnaire sent to the community paediatrician or general practitioner. RESULTS: A total of 111 children who survived infancy after the fetal death of the co-twin (group 1) and 142 from liveborn twin pairs in which one twin died in infancy (group 2) were traced. Responses were received from 97 (87%) and 130 (92%) respectively. In group 1, the cerebral palsy prevalence was 93 (95% confidence interval (CI) 43 to 169) per 1000 infant survivors; it was more common in like-sex pairs (8/70) with a prevalence of 114 (95% CI 51 to 213) compared with 45 (95% CI 1 to 228) per 1000 infant survivors in unlike-sex pairs (1/22). The overall prevalence of neurodevelopmental morbidity (including developmental delay) was 175 (95% CI 106 to 266) per 1000. In group 2, the cerebral palsy prevalence was 154 (95% CI 84 to 223) per 1000 infant survivors in like-sex (16/104) and 77 (95% CI 9 to 251) in unlike-sex (2/26) survivors; the overall prevalence of neurodevelopmental morbidity was 246 (95% CI 172 to 320) per 1000. CONCLUSIONS: The risk of cerebral palsy is increased in the surviving twin after a fetal or infant co-twin death compared with the general twin population. Like-sex twins are at greater risk than unlike-sex. The probable cause, in addition to the consequences of prematurity, is twin-twin transfusion problems associated with monochorionicity.
Authors:
S V Glinianaia; P O D Pharoah; C Wright; J M Rankin;
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Twin Study    
Journal Detail:
Title:  Archives of disease in childhood. Fetal and neonatal edition     Volume:  86     ISSN:  1359-2998     ISO Abbreviation:  Arch. Dis. Child. Fetal Neonatal Ed.     Publication Date:  2002 Jan 
Date Detail:
Created Date:  2002-01-29     Completed Date:  2002-02-12     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  9501297     Medline TA:  Arch Dis Child Fetal Neonatal Ed     Country:  England    
Other Details:
Languages:  eng     Pagination:  F9-15     Citation Subset:  AIM; IM    
Affiliation:
Department of Epidemiology and Public Health, School of Public Health, University of Newcastle, Newcastle upon Tyne NE2 4HH, UK. svetlana.glinianaia@ncl.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Brain Diseases / embryology,  epidemiology,  etiology*
Cause of Death
Cerebral Palsy / embryology,  epidemiology,  etiology
Diseases in Twins / embryology,  epidemiology,  etiology*
England / epidemiology
Female
Fetal Death*
Fetofetal Transfusion / complications
Follow-Up Studies
Gestational Age
Humans
Infant Mortality*
Infant, Newborn
Male
Pregnancy
Prevalence
Risk Factors
Sex Factors
Comments/Corrections

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