Improved Perinatal Mortality in Twins—Changing Practice and Technologies

Hehir, Mark P.; McTiernan, A; Martin, A. J. P.; Carroll, Stephen; Gleeson, R.; Malone, Fergal D.

doi:10.1055/s-0035-1559807

Cited by 6 publications

(5 citation statements)

References 15 publications

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“…Simultaneously, they noted an increase in the rate of Caesarean section. In our material, however, the mode of delivery did not affect PNM, and the CS rate in twins in Finland is lower (increase from 42 to 47% during 1987–2014, presented elsewhere) than the reported 62% in the study by Hehir et al [12, 18].…”

Section: Discussioncontrasting

confidence: 76%

“…Nonetheless, fetal mortality in Finland seems to be among the lowest in Europe [17]. Although declining trends of PNM among twins were noticed also by Hehir et al, their reported mutual PNM rate for both twins remains higher than our results for either of the twins in the end of our study period [18]. Prematurity was the leading cause of PNM in their large cohort.…”

Section: Discussionsupporting

confidence: 49%

“…Generally, the higher PNM in twins compared to singletons is partly explained by twins being more often born preterm and for parents, the burden of having two babies with possible neurological impairment is considerable [18, 19]. Some problems related to prematurity may not arise until school-age, with continuing anxiety during long-term follow-up [9].…”

Section: Discussionmentioning

confidence: 99%

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Perinatal outcomes in Finnish twins: a retrospective study

Rissanen

Jernman

Gissler

et al. 2019

BMC Pregnancy Childbirth

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BackgroundTo establish the changes in perinatal morbidity and mortality in twin pregnancies in Finland, a retrospective register research was conducted. Our extensive data from a 28-year study period provide important information on the outcome of twin pregnancies in Finland that has previously not been reported to this extent.MethodsAll 23,498 twin pregnancies with 46,996 children born in Finland during 1987–2014 were included in the study. Data were gathered from the Medical Birth Register and the Hospital Discharge Register (Finnish Institute for Health and Welfare, Finland) regarding perinatal mortality (PNM) and morbidity. For statistical analysis, binomial regression analysis and crosstabs were performed. The results are expressed in means, percentages and ranges with comparison to singletons when appropriate. Odds ratios from binomial regression analysis are reported. A p-value <0.05 was considered statistically significant.ResultsThere were 46,363 liveborn and 633 stillborn twins in Finland during 1987–2014. Perinatal mortality decreased markedly, from 45.1 to 6.5 per 1000 for twin A and from 54.1 to 11.9 per 1000 for twin B during the study period. Yet, the PNM difference between twin A and B remained. Early neonatal mortality did not differ between twins, but has decreased in both. Asphyxia, respiratory distress syndrome, need for antibiotics and Neonatal Intensive Care Unit (NICU) stay were markedly more common in twin B.ConclusionsIn Finland, PNM and early neonatal mortality in twins decreased significantly during 1987–2014 and are nowadays very low. However, twin B still faces more complications. The outline provided may be used to further improve the monitoring and thus perinatal outcome of twins, especially twin B.

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Section: Discussioncontrasting

confidence: 76%

Section: Discussionsupporting

confidence: 49%

Section: Discussionmentioning

confidence: 99%

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Perinatal outcomes in Finnish twins: a retrospective study

Rissanen

Jernman

Gissler

et al. 2019

BMC Pregnancy Childbirth

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“…Prior to this study, there have been no reliable national estimates of the perinatal mortality rate and neonatal death rate among twins in China. The perinatal mortality rates in our sample were higher than those reported in developed countries (i.e., 6.6‰ in the Netherlands [37], 21.5‰ in Ireland [38] and 20.1‰ in the United States) and lower than those reported in most low- or middle-income countries [11]. Indeed, the observed rate might be even higher if the criterion of perinatal deaths in some countries were adopted (fetal deaths prior to gestational week 28) [9, 39].…”

Section: Discussionmentioning

confidence: 53%

Temporal trends in the birth rates and perinatal mortality of twins: A population-based study in China

et al. 2019

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ObjectiveUntil now, little was known about the epidemiological characteristics of twins in China due to a lack of reliable national data. In this study, we aimed to analyze temporal trends and perinatal mortality of twins from China.MethodsData on twins between 2007 and 2014 were obtained from the China National Population-Based Birth Defects Surveillance System. Twin and singleton deliveries after at least 28 weeks of gestation were recruited and followed until postnatal day 42. Twinning rates were defined as the number of twin individuals per 1000 births(stillbirths and live births). The Weinberg’s differential method was utilized to estimate the number of monozygotic and dizygotic twins.ResultsDuring 2007–2014, the twinning rate increased by 32.3% from 16.4 to 21.7 per 1000 total births with an average of 18.8‰. Among twins, both the perinatal mortality rate (26.1 per 1000 total births) and neonatal death rate (15.7 per 1000 live births) presented a downward tendency but remained at a high level. Large urban-rural and geographic disparities were identified in twinning rates, in perinatal and neonatal mortality, and in their temporal trends.ConclusionsThe upward trend of twinning rates in China paired with the relatively high rates of perinatal and neonatal mortality among twins highlights the need for improved perinatal care in the light of socio-demographic differences.

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“…This study was supported by a study conducted in Korea [30]. The possible explanation could be twin pregnancy is usually associated with prematurity, which is the most common cause of neonatal death and twin-to-twin transfusion syndrome which further leads to death [31]. In addition, twin pregnancy is usually end up with low birth weight which increase child vulnerability to infection and decreases their immunity [27].…”

Section: Discussionmentioning

confidence: 87%

Factors affecting neonatal mortality in the general population: evidence from the 2016 Ethiopian Demographic and Health Survey (EDHS)—multilevel analysis

et al. 2019

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Objective: This study was aimed to identify factors affecting neonatal mortality in Ethiopia. Results:According to the multilevel multivariable logistic regression analysis, the odds of neonatal mortality was significantly associated with husbands with no education (AOR = 2.30, 95% CI 1.10, 4.83), female birth (AOR = 0.57, 95% CI 0.39, 0.83), twin birth (AOR = 13.62, 95% CI 7.14, 25.99), pre-term birth (AOR = 15.07, 95% CI 7.80, 29.12) and mothers with no antenatal care (ANC) visit during pregnancy (AOR = 1.90 95% CI 1.11, 3.25).

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Improved Perinatal Mortality in Twins—Changing Practice and Technologies

Abstract: The perinatal mortality rate in twins improved during the study. The rate of cesarean delivery increased by 1.7% for each year of the study, culminating in a cesarean delivery rate of 62% in 2012. TTTS made a decreasing contribution to the mortality rate in twins during the study.

Cited by 6 publications

References 15 publications

Perinatal outcomes in Finnish twins: a retrospective study

Perinatal outcomes in Finnish twins: a retrospective study

Temporal trends in the birth rates and perinatal mortality of twins: A population-based study in China

Factors affecting neonatal mortality in the general population: evidence from the 2016 Ethiopian Demographic and Health Survey (EDHS)—multilevel analysis

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