Document Detail


Predictors of adverse perinatal outcome in twins delivered at < 37 weeks.
MedLine Citation:
PMID:  15621553     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Multiple gestations are at increased risk for prematurity as well as perinatal mortality and morbidity. The aim of this study was to identify the independent risk factors for adverse perinatal outcome in a large uniform population of twins delivered preterm. METHODS: We accessed a cohort of twin gestations for the period 1990-2000 delivered at < 37.0 weeks gestation. Chorionicity was established by ultrasound assessment of the dividing membrane, neonatal gender and histologic examination of the placenta at birth. Adverse perinatal outcome was defined as stillbirth, neonatal death, or major neonatal complications. Statistical analysis used contingency tables, Student's t test, one-way ANOVA and logistic regression, with a two-tailed p < 0.05 considered significant. RESULTS: A total of 356 twin gestations (712 twins) were included in the database, and 183 twins (25.7%) had adverse perinatal outcome. Logistic regression analysis demonstrated that gestational age at delivery (p < 0.001), premature rupture of membranes (PROM) (p = 0.004), birth weight discordance (p = 0.009), and 5-min Apgar scores (p = 0.001) were significant and independent predictors of adverse perinatal outcome, whereas monochorionicity and twin-twin transfusion syndrome were not. CONCLUSIONS: Gestational age at delivery and birth weight discordance are the most important independent predictors of perinatal mortality or morbidity among preterm twins.
Authors:
Patrizia Vergani; Anna Locatelli; Marta Ratti; Antonietta Scian; Giulia Zangheri; John Pezzullo; Alessandro Ghidini
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Publication Detail:
Type:  Journal Article; Twin Study    
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:  16     ISSN:  1476-7058     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2004 Dec 
Date Detail:
Created Date:  2004-12-28     Completed Date:  2005-05-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  343-7     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynaecology, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy.
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MeSH Terms
Descriptor/Qualifier:
Apgar Score
Birth Weight*
Female
Gestational Age*
Humans
Infant Mortality*
Infant, Newborn
Infant, Premature*
Male
Predictive Value of Tests
Pregnancy
Pregnancy Outcome*
Risk Factors
Twins*
Twins, Dizygotic
Twins, Monozygotic

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


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