TY - JOUR
T1 - Twins versus singleton pregnancies
T2 - outcomes in small for gestational age late preterm deliveries
AU - Walker, Allison R.
AU - Waites, Bethany T.
AU - Caughey, Aaron B.
N1 - Publisher Copyright:
© 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2020/3/18
Y1 - 2020/3/18
N2 - Background: Compared to singleton pregnancies, small for gestational age (SGA) and twin gestations experience adverse maternal and neonatal outcomes. Specific data regarding outcomes in late preterm SGA twin gestations are lacking. Objective: This study sought to compare pregnancy outcomes of late preterm (≥34 and <37 weeks) SGA twins versus singletons. In addition, we sought to stratify the comparisons by <10 and <5 percentile categories. Study design: In this retrospective cohort of 1.85 million pregnancies, we identified 10,646 nonanomalous, SGA, late preterm singleton and twin pregnancies. Births at gestational ages <34 and ≥37 weeks were excluded. Multivariate regression analyses and Chi-squared test were used for statistical comparisons and a p-value of less than 0.05 was used to indicate statistical significance. Results: After controlling for race, education, parity, prenatal care, diabetes, and hypertensive disease, twin pregnancies were less likely to experience neonatal death (aOR 0.14; 95% CI 0.03–0.63; p =.01) and intrauterine fetal demise (IUFD) (aOR 0.16; 95% CI 0.08–0.31; p <.001) compared to SGA <10 percentile singletons. Cesarean rates were higher in SGA <10 [percentile twin pregnancies (aOR 3.40; 95% CI 3.01–3.90; p <.001) as were postpartum hemorrhage (aOR 2.01; 95% CI 1.52–2.67; p <.001) and transfusion (aOR 1.54; 95% CI 1.52–2.67; p =.024). Conclusion: Late preterm SGA twin pregnancies were more like to be complicated by cesarean delivery, postpartum hemorrhage, and maternal transfusion compared to singleton pregnancies. However, neonatal death and IUFD were less common in SGA twin gestations.
AB - Background: Compared to singleton pregnancies, small for gestational age (SGA) and twin gestations experience adverse maternal and neonatal outcomes. Specific data regarding outcomes in late preterm SGA twin gestations are lacking. Objective: This study sought to compare pregnancy outcomes of late preterm (≥34 and <37 weeks) SGA twins versus singletons. In addition, we sought to stratify the comparisons by <10 and <5 percentile categories. Study design: In this retrospective cohort of 1.85 million pregnancies, we identified 10,646 nonanomalous, SGA, late preterm singleton and twin pregnancies. Births at gestational ages <34 and ≥37 weeks were excluded. Multivariate regression analyses and Chi-squared test were used for statistical comparisons and a p-value of less than 0.05 was used to indicate statistical significance. Results: After controlling for race, education, parity, prenatal care, diabetes, and hypertensive disease, twin pregnancies were less likely to experience neonatal death (aOR 0.14; 95% CI 0.03–0.63; p =.01) and intrauterine fetal demise (IUFD) (aOR 0.16; 95% CI 0.08–0.31; p <.001) compared to SGA <10 percentile singletons. Cesarean rates were higher in SGA <10 [percentile twin pregnancies (aOR 3.40; 95% CI 3.01–3.90; p <.001) as were postpartum hemorrhage (aOR 2.01; 95% CI 1.52–2.67; p <.001) and transfusion (aOR 1.54; 95% CI 1.52–2.67; p =.024). Conclusion: Late preterm SGA twin pregnancies were more like to be complicated by cesarean delivery, postpartum hemorrhage, and maternal transfusion compared to singleton pregnancies. However, neonatal death and IUFD were less common in SGA twin gestations.
KW - Intrauterine growth restriction (IUGR)
KW - multiple gestation
KW - prematurity
KW - small for gestational age (SGA)
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U2 - 10.1080/14767058.2018.1508438
DO - 10.1080/14767058.2018.1508438
M3 - Article
C2 - 30078342
AN - SCOPUS:85053500282
SN - 1476-7058
VL - 33
SP - 895
EP - 900
JO - Journal of Maternal-Fetal and Neonatal Medicine
JF - Journal of Maternal-Fetal and Neonatal Medicine
IS - 6
ER -