Document Detail


Perinatal mortality in term and preterm twin and singleton births.
MedLine Citation:
PMID:  12217230     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Although, in general, twins have higher perinatal mortality rates than singletons, preterm twins have lower perinatal mortality rates than singletons of the same birth weight or gestational age. This study investigated the hypotheses that this paradoxical twin advantage: 1) is due to gestational age distribution differences between the singleton and twin populations, and 2) is due to increased likelihood of birth having occurred in a tertiary perinatal center. A pre-existing, time-limited data set of all births in the province of Ontario in odd years between 1979 and 1985 was chosen for this study because of the large sample size (n = 618,579). Multivariable logistic regression of the relationship between perinatal mortality and twin status was controlled for mother's age, hospital level and gestational age. Findings confirm the lower mortality of preterm twins. After controlling for level of hospital of birth this difference remained, suggesting that level of hospital of birth was not a major factor responsible for the twin advantage. Analyses in which gestational age was standardized indicate that, for those whose gestational age was less than 2 SD below the mean for their particular group (twin or singleton), twins were actually at higher risk than singletons. These results support hypothesis 1 and do not strongly support hypothesis 2. The results also support earlier authors' suggestions that the definition of term birth should be different for twins and singletons
Authors:
Jennifer C Payne; M Karen Campbell; Orlando DaSilva; John Koval
Publication Detail:
Type:  Journal Article; Twin Study    
Journal Detail:
Title:  Twin research : the official journal of the International Society for Twin Studies     Volume:  5     ISSN:  1369-0523     ISO Abbreviation:  Twin Res     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-09-09     Completed Date:  2002-10-24     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9815819     Medline TA:  Twin Res     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  260-4     Citation Subset:  IM    
Affiliation:
Surveillance and Risk Assessment Division, Centre for Chronic Disease Prevention and Control, Health Canada, Ottawa, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Gestational Age
Hospitals
Humans
Infant Mortality*
Infant, Newborn
Infant, Premature*
Logistic Models
Multivariate Analysis
Odds Ratio
Risk Factors
Twins*

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


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