Respiratory morbidity in twins by birth order, gestational age and mode of delivery

Bricelj, Katja; Tul, Nataša; Lasič, Mateja; Bregar, Andreja Trojner; Verdenik, Ivan; Lučovnik, Miha; Blickstein, Isaac

doi:10.1515/jpm-2015-0404

Cited by 16 publications

(10 citation statements)

References 22 publications

(31 reference statements)

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“…The response rate was 54%. Out of the 19 authors who responded, 14 could not provide the requested data [ 26 – 39 ], two authors contributed data we could not use [ 40 , 41 ], and three authors provided data we included in our meta-analyses [ 42 – 44 ]. The main reasons for not being able to include studies without author response were absence of stratification of data by gestational age < 28 weeks or birth weight < 1000 g, by birth order or by presentation in the original paper (Additional file 3 ).…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

What is the safest mode of delivery for extremely preterm cephalic/non-cephalic twin pairs? A systematic review and meta-analyses

Dagenais

Lewis-Mikhael

Grabovac

et al. 2017

BMC Pregnancy Childbirth

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BackgroundGiven the controversy around mode of delivery, our objective was to assess the evidence regarding the safest mode of delivery for actively resuscitated extremely preterm cephalic/non-cephalic twin pairs before 28 weeks of gestation.MethodsWe searched Cochrane CENTRAL, MEDLINE, EMBASE and http://clinicaltrials.gov from January 1994 to January 2017. Two reviewers independently screened titles, abstracts and full text articles, extracted data and assessed risk of bias. We included randomized controlled trials and observational studies. Our primary outcome was a composite of neonatal death (<28 days of life) and severe brain injury in survivors (intraventricular hemorrhage grade ≥ 3 or periventricular leukomalacia). We performed random-effects meta-analyses, generating odds ratios with 95% confidence intervals for the first and second twin separately, and for both twins together. We assessed the risk of bias using a modified Newcastle Ottawa Scale (NOS) for observational studies and used Grading of Recommendations Assessment, Development and Evaluation approach (GRADE).ResultsOur search generated 2695 articles, and after duplicate removal, we screened 2051 titles and abstracts, selecting 113 articles for full-text review. We contacted 36 authors, and ultimately, three observational studies met our inclusion criteria. In cephalic/non-cephalic twin pairs delivered by caesarean section compared to vaginal birth at 24+0–27+6 weeks the odds ratio for our composite outcome of neonatal death and severe brain injury for the cephalic first twin was 0.35 (95% CI 0.00–92.61, two studies, I2 = 76%), 1.69 for the non-cephalic second twin (95% CI 0.04–72.81, two studies, I2 = 55%) and 0.83 for both twins (95% CI 0.05–13.43, two studies, I2 = 56%). According to the modified Newcastle Ottawa Scale we assessed individual study quality as being at high risk of bias and according to GRADE the overall evidence for our primary outcomes was very low.ConclusionOur systematic review on the safest mode of delivery for extremely preterm cephalic/non-cephalic twin pairs found very limited existing evidence, without significant differences in neonatal death and severe brain injury by mode of delivery.Electronic supplementary materialThe online version of this article (10.1186/s12884-017-1554-7) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

“…All twins from Boukerrou [ 43 ] and Barzilay [ 44 ] were planned for active resuscitation. Bricelj 2016 [ 42 ] could not confirm active resuscitation for all twins, and therefore we included their data only for twins born at 25 +0 –27 +6 weeks in our analysis.…”

Section: Resultsmentioning

confidence: 99%

What is the safest mode of delivery for extremely preterm cephalic/non-cephalic twin pairs? A systematic review and meta-analyses

Dagenais

Lewis-Mikhael

Grabovac

et al. 2017

BMC Pregnancy Childbirth

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“…This difference between the results of the two studies might be due to the large difference in sample size (114 vs. 679 twins in the Israeli and Korean groups, respectively). Other studies [12] seem to support the pessimistic view.…”

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confidence: 88%

“…Two other papers discuss the issue of "near term" (or the newer nomenclature "late preterm") births in twins, which bear a direct relationship to the clinical, albeit controversial, question of the appropriate timing of twin birth [12]. Simchen and her co-workers [13] observed that a significant proportion of late preterm (34 0/7-35 6/7 weeks) births is iatrogenic.…”

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confidence: 99%

Multiple gestation: more research challenges to come

Blickstein

2016

Journal of Perinatal Medicine

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Nearly 1500 papers were published in the past 5 years with the subject heading of "twin" or "multiple pregnancies". This figure undoubtedly represents the ever increasing interest in this group of high-risk pregnancies. It is very impossible to encompass the myriad issues that caught the attention of clinicians when dealing with difficult clinical cases related to twins and triplets which prompted research. This issue of the Journal of Perinatal Medicine includes 10 papers on various aspects of multiple pregnancy and birth. Three papers deal with the quarter-century-old issue of discordant birth weight [1]. In the first, Biron-Shental and her colleagues [2] evaluated the possible association between intermediate birth weight discordance (> 20% difference) and infertility treatment. As in all likelihood the two embryos were conceived by the same method of infertility treatment [intracytoplasmic sperm injection (ICSI) vs. in vitro fertilization (IVF), ovulation induction vs. IVF, fresh vs. thawed embryos, etc.], the authors unsurprisingly found similar discordant levels as well as similar outcomes. As the authors did not detail the incidence of nulliparas (but the average parity) one is unable to appreciate the influence of this important confounding variable. The second paper reviews available data on outcomes related to estimated fetal weight (EFW) and crown-rump length (CRL) discordance [3]. Whereas the former was found to be associated with adverse outcomes, the latter was not. The authors also wonder about the best cut-off of EFW difference to describe severe discordance. As EFW is a poor predictor of discordance (because of the ± situation that exists [4,5]), one should aim for a higher value (i.e. 25%-30% difference) to avoid over diagnosis. Moreover, it appears that discordance, per se, is not that important unless the smaller twin is small for gestational age (SGA) or exhibits clear growth restriction on repeated scans [i.e. selective intrauterine growth restriction (IUGR)] [6]. In fact, moderate levels of discordance have been shown to be an adaptive measure to increase gestational age.The authors rightly noted the differences between the mechanism and significance of selective IUGR in monochorionic (MC) and dichorionic (DC) twins.Three papers of this batch discuss various aspects of monochorionicity. The Lisbon research group repeated their seminal study related to the prospective risk of intrauterine fetal death in MC twins [7]. Despite the publication of several studies on this subject, significant differences exist in recruitment and management of these sets. Thus, the paper of Simoes and her colleagues [6] showed that, with doubling of the sample size over time since the last report in 2006, and with implementation of intensive prenatal surveillance, a relatively low unexpected fetal death rate after 33 weeks' gestation could be achieved. These findings evidently do not support elective preterm birth for uncomplicated MC twins proposed by several authorities. At present it appears that close surveil...

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“…As mães perceberam o gêmeo primogênito como mais dominante, menos dependente e com menos comportamentos relacionados a conflitos em comparação com o gêmeo que nasceu posteriormente, independentemente da zigosidade. Embora existam poucos estudos que tenham investigado o efeito da ordem de nascimento no relacionamento entre os gêmeos, há evidências de que o gêmeo primogênito tenha mais vantagens, como, por exemplo, maior peso ao nascer (Yokoyama et al, 2016) e menos complicações no nascimento (como síndrome de dificuldade respiratória) (Bricelj et al, 2016), que podem estar relacionadas a diferenças comportamentais nos anos posteriores. Esta relação entre peso corporal e possíveis indicadores de comportamentos de dominância entre gêmeos foi identificado no estudo observacional desenvolvido por Nakamichi (1983).…”

Section: Existe Diferença Entre Os Grupos De Irmãos Gêmeos E Não Gêmeos?unclassified

A natureza da relação gemelar na infância: uma abordagem evolucionista sobre os fatores que influenciam o relacionamento entre irmãos gêmeos

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Escrever esta sessão trouxe à tona muitas memórias e emoções que vivi ao longo desses últimos anos. Ter tido a oportunidade de chegar aqui, hoje, vai muito além da busca por um título -simboliza a vitória da persistência diante de muitos desafios. No entanto, reconheço a minha condição de privilégio, sobretudo, por sempre ter tido duas grandes redes de apoio como suporte nessa caminhada: a rede de Salvador (minha cidade natal) e a de São Paulo (minha cidade do coração). E são para as pessoas destas redes que dedico os meus agradecimentos.Começando pela rede que antecede o mestrado, gostaria de agradecer, primeiramente, aos meus pais por todo o incentivo nessa jornada ainda que esse incentivo implicasse em perdas: imagino que não deve ter sido fácil incentivar o voo da sua única filha para terras tão distantes (porque para mim, não foi fácil largar esse ninho!). Gostaria de agradecer, também, às minhas avós, tias e primas por sempre acreditarem em mim, em especial, à minha prima Luciana por ser a minha maior fonte de inspiração, em todos os aspectos. À Lari e Pim, pela nossa relação forte de primas-irmãs. À Swell, minha figura de apego de quatro patas. Às minhas amigas que sempre estiverem ao meu lado (mesmo longe, fisicamente). À André, por todo apoio e cumplicidade nesta caminhada. Agradeço também aos meus professores da UFBA, em especial, à Profa.Juliana Prates, Marcus Vinícius, Igor Menezes e Ilka Bichara.Dito isso, chega a vez de agradecer à minha rede de apoio paulista: agradeço imensamente à minha orientadora, Emma Otta por ter me dado a oportunidade (em meio a tantas insistências) de correr atrás do meu sonho, de ampliar os meus horizontes e de ter me apresentado o mundo dos gêmeos. Gostaria de agradecer, também, a todos os laços de amizade que construí no laboratório, em especial, à minha "gêmea dizigótica" Bella, pela amizade e por todos os momentos incríveis compartilhados ao longo desses anos. À Ana, pela amizade, "burgões" e paciência em me orientar nas análises estatísticas. À amiga Jani e aos amigos Fernando e Luiz. Agradeço também à Elô, Tânia, Marco, Lucas, Renata, Jonas, Gustavos, Ricardo, Andrea, Vinícius pela parceria e cumplicidade. Às professoras Briseida, Ronara e Patrícia, pela seriedade e competência no mundo acadêmico e por me mostrarem tantas outras possibilidades de estudo na Psicologia Evolucionista. Agradeço também ao professor Nicolas por todo o seu apoio, cuidado e profissionalismo nos momentos difíceis. Por fim, agradeço a todas as mães de gêmeos e não gêmeos que participaram da pesquisa, em especial, à MeTwo pela parceria e divulgação deste trabalho. Agradeço também ao CNPq pelo financiamento da minha pesquisa. RESUMO SHORT, P. C. A. A natureza da relação gemelar na infância: uma abordagem evolucionista sobre os fatores que influenciam o relacionamento entre irmãos gêmeos. (Dissertação Mestrado).

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Respiratory morbidity in twins by birth order, gestational age and mode of delivery

Abstract: Mode of delivery and birth order have a gestational age dependent effect on the incidence of RDS.

Cited by 16 publications

References 22 publications

What is the safest mode of delivery for extremely preterm cephalic/non-cephalic twin pairs? A systematic review and meta-analyses

What is the safest mode of delivery for extremely preterm cephalic/non-cephalic twin pairs? A systematic review and meta-analyses

Multiple gestation: more research challenges to come

A natureza da relação gemelar na infância: uma abordagem evolucionista sobre os fatores que influenciam o relacionamento entre irmãos gêmeos

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