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Factors Associated with Neonatal Problems in Twin Gestations

Published online by Cambridge University Press:  01 August 2014

D. Fraser ,
R. Picard  and
E. Picard
D. Fraser*
Affiliation:
Epidemiology and Health Services Evaluation Unit, Faculty of Health Sciences, Ben-Gurion University of the Negev, Israel
R. Picard
Affiliation:
Division of Obstetrics and Gynecology, Soroka Medical Center, Beer-Sheva, Israel
E. Picard
Affiliation:
Division of Pediatrics, Soroka Medical Center, Beer-Sheva, Israel
*
Departement of Epidemiology, School of Public Health, University of North Carolina, CB 7400, Mcgavran-Greenberg Hall, Chapel Hill, NC 27599-7400, USA

Abstract

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We examined the neonatal outcome of 644 twins weighing 500 g or more and 656 singletons, born in the years 1984-1986 in the Soroka Medical Center, Beer-Sheva, Israel. There was nearly a four-fold risk of antepartum death in twins vs singletons, which disappeared when birth weight was controlled for. The risks for intrapartum and early neonatal mortality were not raised in this population. A statistically significant relative risk for congenital heart malformations in twins vs singletons remained (RR = 5.0, 95% CI = 1.5-16.3), after controlling for maternal age. Significantly higher rates of hyalin membrane disease, hypoglycemia, hyperbilirubinemia, anemia and septicemia were found in twins. Controlling for the confounding of the association between twinning and mortality or morbidity caused by differences in distributions of mode of delivery or gestational age between twins and singletons, was not as efficient as the controlling for birth weight. Thus, adjustment for birth weight removed all the excess risks detected except in hypoglycemia. Our findings suggest that the-lower birth weight of twins, which is so intimately associated with multiple gestations, is probably the single most important factor associated with neonatal problems found in twin births.

Keywords

TwinsMortalityMorbidityCongenital malformationsBirth weight
Type
Research Article
Information
Acta geneticae medicae et gemellologiae: twin research , Volume 40 , Issue 2 , April 1991 , pp. 193 - 200
Copyright
Copyright © The International Society for Twin Studies 1991

References

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