Neurodevelopmental Outcome Among Multiples and Singletons: A Regional Neonatal Intensive Care Unit's Experience in Turkey

Eras, Zeynep; Ozyurt, Banu Mutlu; Kanmaz, Gozde; Erdeve, Ömer; Sakrucu, Evrim Durgut; Oğuz, Şerife Suna; Canpolat, Fuat Emre; Uraş, Nurdan; Dilmen, Uğur

doi:10.1017/thg.2012.155

Cited by 7 publications

(16 citation statements)

References 24 publications

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“…In this sample of extremely preterm infants who survived to follow-up at age 10 years, we found no evidence that twins or triplets (who comprised 35% of this cohort) had worse neurocognitive outcomes than singletons born at the same gestational age. Our findings are consistent with the majority of follow-up studies that assessed children in the pre-school age period,(14, 15, 25, 26) but are in contrast to several prior population-based studies. (2–4, 10) Our findings suggest that the so called “cognitive cost” of being born a twin has diminished or that children born extremely preterm differ from those born at or near term.…”

Section: Discussionsupporting

confidence: 91%

“…Large population-based studies, dating back to the 1950’s, demonstrated a disadvantage of as much as 4 to 5 IQ points among twins, when compared to singletons. (2–4, 10, 13, 27) Relatively recent population-based studies from the Netherlands,(11, 28) and Turkey,(25) however, suggests that twins born at or near term perform as well academically as singletons in adolescence.…”

Section: Discussionmentioning

confidence: 99%

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Neurocognitive function of 10-year-old multiples born less than 28 weeks of gestational age

et al. 2018

J Perinatol

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INTRODUCTION: Few studies have examined the relationship between birth plurality and neurocognitive function among children born extremely preterm. STUDY DESIGN: We compared rates of Z-scores ≤ −2 on 18 tests of neurocognitive function and academic achievement at age 10 years in 245 children arising from twin pregnancies, 55 from triplet pregnancies, and 6 from a septuplet pregnancy to that of 568 singletons, all of whom were born before the 28th week of gestation. RESULTS: 874 children were evaluated at age 10-years. After adjusting for confounders, children of multifetal pregnancies performed significantly better on one of 6 subtests of executive function than their singleton peers. Performance was similar on all other assessments of intelligence, language, academic achievement, processing speed, visual perception, and fine motor skills. CONCLUSION: We found no evidence that children born of multifetal pregnancies had worse scores than their singleton peers on assessments of neurocognitive and academic function.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Neurocognitive function of 10-year-old multiples born less than 28 weeks of gestational age

et al. 2018

J Perinatol

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“…Bodeau-Livinec et al (2013) utilized the Kaufmann Assessment Battery for Children for cognitive assessment, and cerebral palsy was also assessed, while Gnanendran et al (2015) utilized the BSID and Griffiths Mental Development Scales. Hjern et al (2012) utilized test scores from the 'Enlistment Battery 80' , used for military conscription at 18-19 years of age to create an indicator of IQ and grade point averages from the national school register, while Eras et al (2013) utilized the BSID, MDI, and Psychomotor Developmental Index (PDI).…”

Section: Methodsmentioning

confidence: 99%

Neurodevelopmental Outcomes of Twins Compared With Singleton Children: A Systematic Review

et al. 2018

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More than 200 million children aged <5 years fail to reach their full cognitive potential, and children born as twins are particularly at risk. In this article, we review studies that examined differences in the neurodevelopmental outcomes of twins compared to singletons. We searched the Medline database for articles on twins, singletons, neuro, and cognitive development. We also inspected bibliographies of relevant publications to identify related articles from 2011 to 2017. Our search criteria yielded 162 studies, 8 of which met the inclusion criteria. Of the eight studies examined, four were prospective follow-up studies, three were cross-sectional studies, and one was a randomized controlled trial. Five of these studies were carried out in developed countries, and they found no statistically significant difference in neurodevelopmental outcomes among twins and singletons. However, two of the three studies carried out in developing countries found a difference with singletons having significantly higher academic ratings than twins. Studies in which neurodevelopmental outcomes were measured early in life (1-5 years) showed no significant twin-singleton differences, while those in which it was measured later in life showed mixed twin-singleton differences. Overall, these studies may have been underpowered and may not have been optimally designed and implemented. There is need for studies with adequate sample sizes, good design, and optimal measurement of all relevant covariates in order to resolve the conflicting reports in the literature.

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“… Gnanendran et al (2015) reported that multiples (<29 weeks) and similarly preterm singletons at 2–3 years of corrected age did not have significantly higher rates of neurodevelopmental impairment. Similarly, Eras et al (2013) did not find any significant association between multiple birth in preterm infants (≤32 weeks) and increased risk of neurodevelopmental deficits at 12–18 months’ corrected age.…”

Section: Discussionmentioning

confidence: 78%

Neurodevelopmental Outcome and Adaptive Behavior in Preterm Multiples and Singletons at 1 and 2 Years of Corrected Age

et al. 2020

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Background Recent literature has investigated the role of multiple birth on neurodevelopmental outcomes of premature infants, especially extremely preterm ones. Multiple gestations are often associated to increased neurodevelopmental disability. Actually, research findings are controversial. Objective To compare the neurodevelopmental and behavioral outcomes of multiples and singletons in a cohort of preterm infants ≤28 weeks gestational age at 1 and 2 years of corrected age. Methods The study included 86 infants, born from January 2014 to September 2017 and enrolled in the follow-up program provided at authors’ Institution. Exclusion criteria included: major brain lesions and malformations, severe neuro-sensorial deficits, genetic syndromes, single-twin survivors. Thirty four multiples were compared to 52 singletons, using the Griffiths Mental Development Scales and the Child Behavior Checklist 1½–5. Statistical analysis was based on ANOVA techniques to test group differences. A p < 0.05 was considered statistically significant. Results The neurodevelopmental outcomes of multiples and singletons at 1 and 2 years of corrected age did not significantly differ at a general level ( p > 0.05). Multiples showed significantly lower mean scores than singletons at 1 year in Locomotor (87.15 ± 11.94 vs. 92.48 ± 11.59) and Personal-Social (84.88 ± 10.25 vs. 89.63 ± 8.19) subscales. Considering the behavioral outcomes, higher rates of externalizing problems were observed in multiples at 2 years (54.27 ± 9.64 vs. 49.31 ± 10.39). Conclusion The slightly lower neurodevelopmental outcome showed by multiples, especially in the gross-motor and personal-social domains at 1 year, might be related to the specific environmental condition they experience. Multiple birth may affect mother’s sensitivity to infant’s needs and infant’s acquisition of emotional and behavioral regulation. This affects the separation process and the acquisition of the independent walking and other gross-motor skills. Being multiples might also induce an hyperstimulation and this could explain their higher vulnerability to externalizing problems (impulsiveness, hyperactivity, attention deficits). Additionally, males are more affected by the multiple condition than females.

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Neurodevelopmental Outcome Among Multiples and Singletons: A Regional Neonatal Intensive Care Unit's Experience in Turkey

Cited by 7 publications

References 24 publications

Neurocognitive function of 10-year-old multiples born less than 28 weeks of gestational age

Neurocognitive function of 10-year-old multiples born less than 28 weeks of gestational age

Neurodevelopmental Outcomes of Twins Compared With Singleton Children: A Systematic Review

Neurodevelopmental Outcome and Adaptive Behavior in Preterm Multiples and Singletons at 1 and 2 Years of Corrected Age

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