Twin–singleton influence on infant development: a national birth cohort study

Lung, For‐Wey; Shu, Bih‐Ching; Chiang, Tung Liang; Lin, Shio Jean

doi:10.1111/j.1365-2214.2009.00963.x

Cited by 31 publications

(36 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The association between occupation and multiple gestations was rarely reported in other studies. The increased risk among mothers with full-time employment may reflect their higher economic capacity to access infertility treatments with a greater possibility of multiple gestations compared to unemployed mothers (25). However, the contribution of ART in the present study appeared uncertain (23).…”

Section: Discussionmentioning

confidence: 99%

“…(25). Conceptually, this observation suggests that the neonatal morbidities associated with multiple births can be curtailed by addressing these prenatal factors.…”

Section: Discussionmentioning

confidence: 99%

“…Conceptually, this observation suggests that the neonatal morbidities associated with multiple births can be curtailed by addressing these prenatal factors. However, several studies have demonstrated that multiple births are still independently at an increased risk of neurodevelopmental disabilities, such as cerebral palsy, learning disability, epilepsy, and overall developmental deficits even after adjusting for these factors (1-3,14,16,25). For example, there are indications that cerebral palsy in multiple births is not only attributable partly to prematurity or low birthweight but also to other factors inherent in twinning that are potential modulators of adverse neurodevelopmental outcomes in-utero, such as death of a co-twin, sex discordance, birthweight discordance, twin-twin transfusion, and ART (14).…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Perinatal Outcomes of Multiple Births in Southwest Nigeria

Olusanya

2012

J Health Popul Nutr

View full text Add to dashboard Cite

Compared to singletons, multiple births are associated with a substantially-higher risk of maternal and perinatal mortality worldwide. However, little evidence exists on the perinatal profile and risk of neurodevelopmental disabilities among the survivors, especially in developing countries. This cross-sectional study, therefore, set out to determine the adverse perinatal outcomes that are potential markers for neurodevelopmental disabilities in infants with multiple gestations in a developing country. In total, 4,573 mothers, and their 4,718 surviving offspring in an inner-city maternity hospital in Lagos, Nigeria, from May 2005 to December 2007, were recruited. Comparisons of maternal and infant outcomes between single and multiple births were performed using multivariable logistic regression and generalized estimation equation analyses. Odds ratio (OR) and the corresponding 95% confidence interval (CI) for each marker were estimated. Of the 4,573 deliveries, there were 4,416 (96.6%) singletons and 157 (3.4%) multiples, comprising 296 twins and six triplets together (6.4% of all live 4,718 infants). After adjusting for maternal age, ethnicity, occupation, parity, and antenatal care, multiple gestations were associated with increased risks of hypertensive disorders and caesarean delivery. Similarly, after adjusting for potential maternal confounders, multiple births were associated with low five-minute Apgar score (OR: 1.47, 95% CI 1.13-1.93), neonatal sepsis (OR: 2.16, 95% CI 1.28-3.65), severe hyperbilirubinaemia (OR: 1.60, 95% CI 1.00-2.56), and admission to a special-care baby unit (OR: 1.56, 95% CI 1.12-2.17) underpinned by preterm delivery before 34 weeks (OR: 1.91, 95% CI 1.14-3.19), birthweight of less than 2,500 g (OR: 6.45, 95% CI 4.80-8.66), and intrauterine growth restriction (OR: 9.04, 95% CI 6.62-12.34). Overall, the results suggest that, in resourcepoor settings, infants of multiple gestations are associated with a significantly-elevated risk of adverse perinatal outcomes. Since these perinatal outcomes are related to the increased risk of later neurodevelopmental disabilities, multiple-birth infants merit close developmental surveillance for timely intervention.

show abstract

Section: Discussionmentioning

confidence: 99%

“…(25). Conceptually, this observation suggests that the neonatal morbidities associated with multiple births can be curtailed by addressing these prenatal factors.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Perinatal Outcomes of Multiple Births in Southwest Nigeria

Olusanya

2012

J Health Popul Nutr

View full text Add to dashboard Cite

show abstract

“…Neurodevelopment is multifaceted, and factors like birthweight, weight increase after birth, gender, breastfeeding, maternal age, education, and parity are reported to have an impact on neurodevelopment [19]. However, ASQ total score, problem solving, personal-social functioning, and fine motor score still increased significantly with maternal selenium tertiles in pregnancy week 18, even when such factors were included in the multiple linear regression models.…”

Section: Discussionmentioning

confidence: 99%

“…Multiple linear regression models were used to assess the relationship between ASQ scores at 6 months and maternal selenium status during pregnancy. The unstandardized coefficient (B) represents an estimate of the standardized β coefficient, and the models also included variables chosen due to their reported impact for neurodevelopment [19]. Logistic regressions models, including factors considered to be related to the risk of infection during the first weeks of life, were used to assess the risk of having an infant infection during the first 6 weeks of life in relation to maternal selenium levels during pregnancy and postpartum.…”

Section: Methodsmentioning

confidence: 99%

Impact of Maternal Selenium Status on Infant Outcome during the First 6 Months of Life

et al. 2017

View full text Add to dashboard Cite

Pregnant women and infants are at risk for selenium deficiency, which is known to have negative effects on immune and brain function. We have investigated selenium levels in 158 healthy never-pregnant women and in 114 pregnant and lactating women and their infants at age 6 months and related this to clinical outcomes during the first 6 months of life. Neurodevelopment was assessed with the parental questionnaire Ages and Stages (ASQ) at 6 months. A maternal selenium level ≤0.90 µmol/L in pregnancy week 18 was negatively related to infant neurodevelopment at 6 months (B = −20, p = 0.01), whereas a selenium level ≤0.78 µmol/L in pregnancy week 36 was associated with an increased risk (odds ratio 4.8) of having an infant infection during the first 6 weeks of life. A low maternal selenium status in pregnancy was found to be associated with an increased risk of infant infection during the first 6 weeks of life and a lower psychomotor score at 6 months. We suggest a cutoff for maternal serum selenium deficiency of 0.90 µmol/L in pregnancy week 18 and 0.78 µmol/L in pregnancy week 36. This should be reevaluated in an intervention study.

show abstract

Maternal prepregnancy obesity and achievement of infant motor developmental milestones in the upstate KIDS study

Wylie

Sundaram

Kus

et al. 2015

Obesity

View full text Add to dashboard Cite

ObjectiveMaternal pre-pregnancy obesity is associated with several poor infant health outcomes; however studies that investigated motor development have been inconsistent. Thus, we examined maternal pre-pregnancy weight status and infants’ gross motor development.Design and MethodsParticipants consisted of 4,901 mother-infant pairs from the Upstate KIDS study, a longitudinal cohort in New York. Mothers indicated dates when infants achieved each of six gross motor milestones when infants were 4, 8, 12, 18, and 24 months old. Failure time modeling under a Weibull distribution was utilized to compare time to achievement across three levels of maternal pre-pregnancy BMI. Hazard ratios below one indicate a lower “risk” of achieving the milestone and translate to later achievement.ResultsCompared to infants born to thin and normal weight mothers (BMI <25), infants born to obese mothers (BMI>30) were slower to sit without support [HR=0.91, p=0.03] and crawl on hands and knees [HR=0.86, p<0.001], after adjusting for maternal and birth characteristics. Increased gestational age was associated with faster achievement of all milestones but additional adjustment did not impact results.ConclusionsMaternal pre-pregnancy obesity was associated with a slightly longer time for infant to sit and crawl, potentially due to a compromised intrauterine environment or reduced physically active play.

show abstract

Twin–singleton influence on infant development: a national birth cohort study

Abstract: The conceptual construct of structural equation modelling showed these factors interacted and influenced children's development through multiple pathways. Medical intervention may facilitate children's development through prenatal growth and premature care.

Cited by 31 publications

References 29 publications

Perinatal Outcomes of Multiple Births in Southwest Nigeria

Perinatal Outcomes of Multiple Births in Southwest Nigeria

Impact of Maternal Selenium Status on Infant Outcome during the First 6 Months of Life

Maternal prepregnancy obesity and achievement of infant motor developmental milestones in the upstate KIDS study

Contact Info

Product

Resources

About