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Intrauterine fetal death of one twin of Diamnionic twins is associated with adverse perinatal outcome of the co-twin.
MedLine Citation:
PMID:  22111811     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Abstract Objective: To determine whether intrauterine fetal death (IUFD) of one twin of Diamnionic twins after 22 weeks gestation is associated with adverse perinatal outcome to the co-twin. Method: A retrospective case-control study (n=4070) including all twin births delivered between the years 1988-2010, was conducted. Perinatal outcome of the co-twin in Diamnionic pregnancies complicated by IUFD were compared to the first twin from a pair of live-born Diamnionic twins. A multiple logistic regression model was constructed to determine the association between IUFD of one twin and postpartum death of the co-twin while controlling for confounders such as gestational age. Results: Pregnancies complicated with IUFD of a co-twin (n=116) had higher rates of adverse perinatal outcomes such as post-partum death (9.5% vs. 2.3%, P<0.001), low Apgar scores (<7) at 1 and 5 minutes (30.2% vs. 10.6%, P<0.001 and 6.9% vs. 1.8%, P<0.001, respectively), lower birth weight (1953±746gr vs. 2299±559gr), and higher rates of preterm birth before 34 weeks gestation (38.8% vs. 16.4%, P<0.001). Using a multivariate analysis with postpartum death as the outcome variable, mortality was attributed to gestational age (adjusted OR = 0.58; 95% CI 0.5-0.6, P<0.001) and not to the IUFD per-se (adjusted OR=1.3, 95% CI 0.5-3.3, P=0.552). Conclusion: Intrauterine fetal death of one twin (of Diamnionic twins) is associated with adverse perinatal outcome of the co-twin mainly due to prematurity.
Authors:
Uriel Giwnewer; Arnon Wiznitzer; Jordana Mashiach Friedler; Ruslan Sergienko; Eyal Sheiner
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-23
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  -     ISSN:  1476-4954     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
The Joyce and Irving Goldman Medical school, Faculty of Health Sciences, Soroka University Medical Center, Ben Gurion University of the Negev, Be'er-Sheva, Israel.
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