Perinatal outcome of singleton versus twin late preterm infants: do twins mature faster than singletons?

Ribičić, Rebeka; Kranjčec, Izabela; Borošak, Jesenka; Tumbri, Jasna; Prajz, Lorita Mihovilović; Ribičić, Tomislav

doi:10.3109/14767058.2015.1053449

Cited by 19 publications

(16 citation statements)

References 21 publications

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“…The mode of delivery in twin pregnancy is still controversial [ 10 19 20 ]; however, cesarean section is preferred in our institution because of safety concerns. In neonatal characteristics, mean birth weight was smaller in twin groups similar to previous studies [ 7 17 ]. The growth of twins differed from that of singleton after 33 weeks of gestation [ 22 ] and twin fetuses were expected to be approximately 121 go lighter than singleton on average [ 23 ].…”

Section: Discussionsupporting

confidence: 89%

“…And the authors suggested that this result would be associated with acceleration of lung maturation and higher rate of antenatal corticosteroid administration in twin group [ 17 ]. On the other hand, Ribicic et al [ 7 ] reported there were no differences in the rate of TTN and RDS despite of higher rate of cesarean delivery in twin group. And they also suggested this result would be a higher rate of antenatal corticosteroid administration and of higher rate female gender in twin group.…”

Section: Discussionmentioning

confidence: 98%

“…However, there were only 4 cases of GDM in our twin groups; therefore, we did not include GDM as variables. Previous studies showed the rate of hyperbilirubinemia requiring phototherapy was higher in the singleton group and the authors it would be related with higher rate of breastfeeding in singleton group [ 7 17 ]. We considered only neonatal outcomes (not infantile outcomes) and we presumed breastfeeding rate was similar in the first few weeks of life; therefore, the rate of phototherapy was similar between 2 groups in our study.…”

Section: Discussionmentioning

confidence: 99%

“…However, about 20% of late preterm births in twin pregnancies did not have any definitive maternal or fetal indication for delivery [ 6 ]. This practice may be based on the clinical impression that twin fetuses have more rapid pulmonary maturation than singleton [ 7 ] and on several epidemiologic studies showing that the lowest perinatal mortality rate for twins occurs at an earlier gestational age, and preventing unexplained fetal death in twin pregnancies [ 8 9 10 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…Also, studies on comparison of perinatal outcome between twin and singleton have been about extremely premature neonates [ 16 ]. Moreover, there have been sparse studies comparing twin and singleton pregnancies in the late preterm period showing conflict conclusions [ 7 17 ]. Therefore, in this study we aimed to determine whether late preterm twin neonates have a more favorable perinatal outcome than singleton late preterm neonates.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of perinatal outcomes in late preterm birth between singleton and twin pregnancies

et al. 2017

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ObjectiveTo determine whether late preterm twin neonates have a more favorable perinatal outcome than singleton late preterm neonates.MethodsWe studied 401 late preterm births between 34+0 and 36+6 weeks of gestation, from January 2011 to December 2014 in our institution. We compared the maternal and neonatal characteristics and perinatal outcomes between singleton and twin pregnancies. Perinatal outcomes included Apgar score, admission to the neonatal intensive care unit (NICU) or special care nursery, duration of NICU stay, and the rate of composite morbidity (antibiotic use, hypoglycemia, hypocalcemia, hyperbilirubinemia requiring phototherapy, respiratory support, and respiratory distress syndrome).ResultsA total of 289 neonates were in the singleton group and 112 in the twin group. The twin group showed smaller mean birth weight despite of longer gestational age at delivery. In addition, there were significant differences in the indication of delivery and cesarean section rate between the 2 groups. Overall, the risk of composite morbidity was similar between 2 groups (odds ratio, 1.4; 95% confidence interval, 0.8 to 2.4).ConclusionOur findings suggest that late preterm twins do not show a more favorable outcome than singleton late preterm births.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of perinatal outcomes in late preterm birth between singleton and twin pregnancies

et al. 2017

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Mother–child separation after twin birth in a maternity unit with an appropriate level of neonatal care

Pauphilet

Goffinet

Korb

et al. 2023

Intl J Gynecology & Obste

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ObjectiveTo evaluate the mother–child separation rate in twin pregnancies delivered in maternity units offering an appropriate level of neonatal care.MethodsJUMODA is a French, prospective, population‐based cohort study of twin deliveries, including 7998 women who gave birth in maternity units with appropriate levels of neonatal care based on thresholds for weeks of gestational age (wGA) and birth weight according to French guidelines: level I (≥36 wGA), IIA (≥34 wGA), IIB (≥32 wGA and ≥ 1500 g), and IIII (<32 wGA or < 1500 g). The primary outcome was mother–child separation, defined as the transfer of at least one twin or the mother to another hospital.ResultsMother–child separation occurred in 2.1% of pregnancies. This rate was significantly higher in level I (4.8%, 95% confidence interval [CI] 1.5–12.5) and IIA (3.4%, 95% CI 2.4–4.7) compared with level IIB (1.6%, 95% CI 1.1–2.3) and level III maternity units (2.1%, 95% CI 1.9–2.8). In level IIA units, the rate of mother–child separation was higher for babies born between 34 and 36 wGA (8.3%) than for those born at 36 wGA or beyond (1.7%). In level IIb, the rate of mother–child separation for babies born between 32 and 34 wGA (7.5%) was higher than for those born between 34 and 36 wGA (2.1%) and at 36 wGA or beyond (0.9%).ConclusionMother–child separation rates were low but differed by level of care. By using specific thresholds for twins to define levels of care, rather than data from singleton births, one‐fifth of mother–child separations could have been avoided.

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Use of Concentrated Parenteral Nutrition Solutions Is Associated With Improved Nutrient Intakes and Postnatal Growth in Very Low‐Birth‐Weight Infants

Späth

Zamir

Sjöström

et al. 2019

J Parenter Enteral Nutr

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Background Evidence showing the beneficial effects of enhanced parenteral nutrition (PN) to very low‐birth‐weight (VLBW, <1500 g) infants is accumulating. However, PN composition and its impact on growth outcomes are questioned. This study aimed to investigate the associations between administration of a concentrated PN regime and intakes of energy and macronutrients as well as postnatal growth in VLBW infants. Methods We compared 2 cohorts of VLBW infants born before (n = 74) and after (n = 44) a concentrated PN regime was introduced into clinical use. Daily nutrition and fluid intake during the first 28 postnatal days and all available growth measurements during hospitalization were retrospectively collected from clinical charts. Results Infants who received concentrated PN compared with original PN had higher parenteral intakes of energy (56 vs 45 kcal/kg/d, P < 0.001), protein (2.6 vs 2.2 g/kg/d, P = 0.008), and fat (1.5 vs 0.7 g/kg/d, P < 0.001) during the first postnatal week. Changes in standard deviation scores for weight and length from birth to postnatal day 28 were more positive in the concentrated PN group (mean [95% CI]; weight change: –0.77 [–1.02 to –0.52] vs –1.29 [–1.33 to –1.05], P = 0.005; length change: –1.01 [–1.36 to –0.65] vs –1.60 [–1.95 to –1.25], P = 0.025). There were no significant differences in fluid intake and infant morbidity between the groups. Conclusion Our results suggest that concentrated PN is useful and seems to be safe for improving early nutrition and growth in VLBW infants.

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Perinatal outcome of singleton versus twin late preterm infants: do twins mature faster than singletons?

Cited by 19 publications

References 21 publications

Comparison of perinatal outcomes in late preterm birth between singleton and twin pregnancies

Comparison of perinatal outcomes in late preterm birth between singleton and twin pregnancies

Mother–child separation after twin birth in a maternity unit with an appropriate level of neonatal care

Use of Concentrated Parenteral Nutrition Solutions Is Associated With Improved Nutrient Intakes and Postnatal Growth in Very Low‐Birth‐Weight Infants

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