Fetal or infant death in twin pregnancy: neurodevelopmental consequence for the survivor

Glinianaia, SV; Pharoah, P. O. D.; Wright, Chris; Rankin, Judith

doi:10.1136/fn.86.1.f9

Cited by 68 publications

(37 citation statements)

References 34 publications

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“…However, even in the absence of either TTTS or single IUFD, antenatal necrosis of the cerebral white matter was reported on early neonatal brain scans in 23% of preterm monochorionic twins compared with 3% in preterm dichorionic twins, suggesting that the monochorionic placenta accounts for this difference (Denbow et al, 1998;Lewi et al, 2003;Sebire et al, 1997). Although we found neurological impairment in only one surviving fetus (3.1%) with periventricular echodensities on cerebral ultrasound, Glinianaia et al (2002) reported a high incidence of neurodevelopmental morbidity (17.5%). Bejar et al (1989) demonstrated that in multiple gestations necrosis of cerebral white matter leading to cavitary lesions, brain atrophy, and gliosis may occur with an incidence of 13.8%.…”

Section: Twin Research February 2004contrasting

confidence: 40%

See 1 more Smart Citation

The Outcome of Twin Pregnancies Complicated by Single Fetal Death After 20 Weeks of Gestation

Aslan¹,

Gül²,

Cebeci³

et al. 2004

Twin Res

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Section: Twin Research February 2004contrasting

confidence: 40%

“…This is mostly due to TTTS which was responsible for 25% of the single fetal deaths in our series. Glinianaia et al (2002) found 8.4% of infant mortality in which 6 of 11 cases were TTTS. Is TTTS itself or extreme prematurity responsible for the morbidity and mortality in pregnancies complicated with single fetal death?…”

Section: Twin Research February 2004mentioning

confidence: 99%

The Outcome of Twin Pregnancies Complicated by Single Fetal Death After 20 Weeks of Gestation

Aslan¹,

Gül²,

Cebeci³

et al. 2004

Twin Res

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“…18 Probabilities for miscarriage, stillbirth, preterm birth, neonatal morbidity, neonatal mortality and longterm complications were adjusted upwards for monozygotic twins following eSET, using relative risk estimates derived from the literature. [19][20][21][22][23] In addition, we adjusted the disability incidence upwards for twin survivors where the co-twin was stillborn or died during the neonatal period, by applying an odds ratio of 2.4 24 to the incidence rate observed in surviving twin pairs. 18 As neonatal event rates for twins are generally reported on a per twin infant basis, some assumptions were required regarding the concordance of adverse neonatal outcomes among liveborn twin pairs.…”

Section: Clinical Inputsmentioning

confidence: 99%

Minimising twins in in vitro fertilisation: a modelling study assessing the costs, consequences and cost-utility of elective single versus double embryo transfer over a 20-year time horizon

Scotland

McLernon

Kurinczuk

et al. 2011

BJOG: An International Journal of Obstetrics &Amp; Gynaecology

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Objectives To assess the cumulative costs and consequences of double embryo transfer (DET) or elective single embryo transfer (eSET) in women commencing in vitro fertilisation (IVF) treatment aged 32, 36 and 39 years. Design Microsimulation model.Setting Three assisted reproduction centres in Scotland.Sample A total of 6153 women undergoing treatment at one of three Scottish IVF clinics, between January 1997 and June 2007.Methods A microsimulation model, populated using data inputs derived from a large clinical data set and published literature, was developed to compare the costs and consequences of using eSET or DET over multiple treatment cycles.Main outcome measures Disability-free live births; twin pregnancy rate; women's quality-adjusted life-years (QALYs); health service costs.Results Not only did DET produce a higher cumulative live birth rate compared with eSET for women of all three ages, but also a higher twin pregnancy rate. Compared with eSET, DET ranged from costing an additional £27 356 per extra live birth in women commencing treatment aged 32 years, to costing £15 539 per extra live birth in 39-year-old women. DET cost £28 300 and £20 300 per additional QALY in women commencing treatment aged 32 and 39 years, respectively.Conclusions Considering the high twin pregnancy rate associated with DET, coupled with uncertainty surrounding QALY gains, eSET is likely to be the preferred option for most women aged £36 years. The cost-effectiveness of DET improves with age, and may be considered cost-effective in some groups of older women. The decision may best be considered on a case-by-case basis for women aged 37-39 years.Keywords Cost-effectiveness, in vitro fertilisation, single embryo transfer.Please cite this paper as: Scotland G, McLernon D, Kurinczuk J, McNamee P, Harrild K, Lyall H, Rajkhowa M, Hamilton M, Bhattacharya S. Minimising twins in in vitro fertilisation: a modelling study assessing the costs, consequences and cost-utility of elective single versus double embryo transfer over a 20-year time horizon.

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“…MORTALITY OR CEREBRAL PALSY IN TWINS population (34) and for rates of CP following fetal or neonatal death of the co-twin in a different population (35).…”

mentioning

confidence: 99%

The Risk of Mortality or Cerebral Palsy in Twins: A Collaborative Population-Based Study

et al. 2002

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The purpose of the paper was to describe demographic and clinical factors associated with fetal or neonatal death or cerebral palsy (CP) in twins. Vital statistics from five populations in the United States and Australia, which included information on CP diagnosed after 1 y of age. Information on zygosity was not available. In 1,141,351 births, 25,772 of whom were twins, significant secular trends from 1980 to 1989 included increasing prevalence of twins, increasing proportion of unlike-sex twins, and increasing maternal age. Overall, twins were at an approximately 5-fold increased risk of fetal death, 7-fold increased risk of neonatal death, and 4-fold increased risk of CP compared with singletons. However, at birth weight Ͻ2500 g, twins generally did better than singletons, both with respect to mortality and to CP rates. Second-born twins and twins from same-sex pairs were at increased risk of early death but not of CP. Twins from growth-discordant pairs and twins whose co-twin died were at increased risk of both mortality and CP. The highest rates of CP were in surviving twins whose co-twin was still-born (4.7%), died shortly after birth (6.3%) or had CP (11.8%). In this large data set spanning a 10-y period, overall rates of death or cerebral palsy were higher in twins than singletons, although small twins generally did better than small singletons. Co-twin death was a strong predictor of CP in surviving twins. This risk was the same for same-and different-sex pairs, and observed both for preterm and term infants. The prevalence of multiple births has increased in recent years (1-3), making the identification of factors that influence outcome in these infants increasingly important from a public health perspective. Infants from multiple births are known to be at higher risk of cerebral palsy (CP) than singleton infants (4 -7). As the risk of CP is strongly related to low birth weight or immaturity, and twin infants are on average smaller and born earlier than singleton infants, it is necessary to separate the influence of birth weight from other factors which may independently predict unfavorable outcome.The aim of this study is to describe the risk of CP in a large population-based cohort of over one million births, of whom more than 20,000 were twins. Our data came from five populations in Australia and the United States (9).* Demographic characteristics were derived from birth records and supplemented by perinatal death certifications and CP diagnoses obtained from registers with a high ascertainment of cases.Twins are more likely than singletons to die as infants (4, 8 -10), precluding a diagnosis of CP which generally cannot be made with confidence until months or years after birth. Our primary purpose was to explore factors related to CP risk in Received June 26, 2001; accepted April 15, 2002

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Fetal or infant death in twin pregnancy: neurodevelopmental consequence for the survivor

Cited by 68 publications

References 34 publications

The Outcome of Twin Pregnancies Complicated by Single Fetal Death After 20 Weeks of Gestation

The Outcome of Twin Pregnancies Complicated by Single Fetal Death After 20 Weeks of Gestation

Minimising twins in in vitro fertilisation: a modelling study assessing the costs, consequences and cost-utility of elective single versus double embryo transfer over a 20-year time horizon

The Risk of Mortality or Cerebral Palsy in Twins: A Collaborative Population-Based Study

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