Abstract
BACKGROUND: Twin birthweight discordance is associated with adverse outcomes. OBJECTIVE: To determine what degree of twin birthweight discordance is associated with adverse outcomes. STUDY DESIGN: This is a retrospective cohort study of twins with vertex twin A delivered vaginally at 36 to 40 weeks (U.S. Vital Statistics Natality birth certificate registry data 2012-2014). The primary outcome was a composite of neonatal morbidity: 5-minute Apgar < 7, neonatal intensive care unit admission, neonatal mechanical ventilation > 6 hours, neonatal seizure, and/or neonatal transport to a higher level of care. Effect estimates were expressed as incidence rate and adjusted odds ratio (aOR) controlling for confounding using multivariate clustered analysis for between-pair effects, and multilevel random effect generalized estimating equation regressions to account for within-pair effects. We adjusted for sex discordance, breech delivery of the second twin, maternal race/ethnicity, nulliparity, age, marital status, obesity, and socioeconomic status. RESULTS: In comparison to birthweight discordance of ≤20%, aORs with 95% confidence intervals (CIs) by weight discordance of the primary outcome among 27,276 twin deliveries were as follows: 20.01 to 25% (aOR: 1.46 [95% CI: 1.29-1.65]); 25.01 to 30% (aOR: 1.96 [95% CI: 1.68-2.29]); and 30.01 to 60% (aOR: 2.97 [95% CI: 2.52-3.50]). CONCLUSION: Twin birthweight discordance >20% was associated with increased odds of adverse neonatal outcome.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 969-974 |
| Number of pages | 6 |
| Journal | American journal of perinatology |
| Volume | 36 |
| Issue number | 9 |
| DOIs | |
| State | Published - Jul 1 2019 |
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ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Obstetrics and Gynecology
Cite this
Association between the Degree of Twin Birthweight Discordance and Perinatal Outcomes. / Kim, Lena H.; Caughey, Aaron; Yee, Lynn M.; Cheng, Yvonne W.
In: American journal of perinatology, Vol. 36, No. 9, 01.07.2019, p. 969-974.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Association between the Degree of Twin Birthweight Discordance and Perinatal Outcomes
AU - Kim, Lena H.
AU - Caughey, Aaron
AU - Yee, Lynn M.
AU - Cheng, Yvonne W.
PY - 2019/7/1
Y1 - 2019/7/1
N2 - BACKGROUND: Twin birthweight discordance is associated with adverse outcomes. OBJECTIVE: To determine what degree of twin birthweight discordance is associated with adverse outcomes. STUDY DESIGN: This is a retrospective cohort study of twins with vertex twin A delivered vaginally at 36 to 40 weeks (U.S. Vital Statistics Natality birth certificate registry data 2012-2014). The primary outcome was a composite of neonatal morbidity: 5-minute Apgar < 7, neonatal intensive care unit admission, neonatal mechanical ventilation > 6 hours, neonatal seizure, and/or neonatal transport to a higher level of care. Effect estimates were expressed as incidence rate and adjusted odds ratio (aOR) controlling for confounding using multivariate clustered analysis for between-pair effects, and multilevel random effect generalized estimating equation regressions to account for within-pair effects. We adjusted for sex discordance, breech delivery of the second twin, maternal race/ethnicity, nulliparity, age, marital status, obesity, and socioeconomic status. RESULTS: In comparison to birthweight discordance of ≤20%, aORs with 95% confidence intervals (CIs) by weight discordance of the primary outcome among 27,276 twin deliveries were as follows: 20.01 to 25% (aOR: 1.46 [95% CI: 1.29-1.65]); 25.01 to 30% (aOR: 1.96 [95% CI: 1.68-2.29]); and 30.01 to 60% (aOR: 2.97 [95% CI: 2.52-3.50]). CONCLUSION: Twin birthweight discordance >20% was associated with increased odds of adverse neonatal outcome.
AB - BACKGROUND: Twin birthweight discordance is associated with adverse outcomes. OBJECTIVE: To determine what degree of twin birthweight discordance is associated with adverse outcomes. STUDY DESIGN: This is a retrospective cohort study of twins with vertex twin A delivered vaginally at 36 to 40 weeks (U.S. Vital Statistics Natality birth certificate registry data 2012-2014). The primary outcome was a composite of neonatal morbidity: 5-minute Apgar < 7, neonatal intensive care unit admission, neonatal mechanical ventilation > 6 hours, neonatal seizure, and/or neonatal transport to a higher level of care. Effect estimates were expressed as incidence rate and adjusted odds ratio (aOR) controlling for confounding using multivariate clustered analysis for between-pair effects, and multilevel random effect generalized estimating equation regressions to account for within-pair effects. We adjusted for sex discordance, breech delivery of the second twin, maternal race/ethnicity, nulliparity, age, marital status, obesity, and socioeconomic status. RESULTS: In comparison to birthweight discordance of ≤20%, aORs with 95% confidence intervals (CIs) by weight discordance of the primary outcome among 27,276 twin deliveries were as follows: 20.01 to 25% (aOR: 1.46 [95% CI: 1.29-1.65]); 25.01 to 30% (aOR: 1.96 [95% CI: 1.68-2.29]); and 30.01 to 60% (aOR: 2.97 [95% CI: 2.52-3.50]). CONCLUSION: Twin birthweight discordance >20% was associated with increased odds of adverse neonatal outcome.
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U2 - 10.1055/s-0038-1675769
DO - 10.1055/s-0038-1675769
M3 - Article
VL - 36
SP - 969
EP - 974
JO - American Journal of Perinatology
JF - American Journal of Perinatology
SN - 0735-1631
IS - 9
ER -