Specialized prenatal care and maternal and infant outcomes in twin pregnancy

OBJECTIVE: This study was undertaken to evaluate the effect of a prenatal nutrition and education program on twin pregnancy, neonatal, and early childhood outcomes. STUDY DESIGN: This prospective intervention study of women who participated in a specialized program (Program Pregnancies) versus nonparticipants included twice-monthly visits, dietary prescription of 3000 to 4000 kcal per day, multimineral supplementation, and patient education. RESULTS: Program Pregnancies were associated with improved pregnancy outcomes (preeclampsia, adjusted odds ratio [AOR] 0.41, 95% Cl, 0.23-0.75; preterm premature rupture of membranes, AOR 0.35, 95% Cl, 0.20-0.60; delivery < 36 weeks, AOR 0.62, 95% Cl, 0.43-0.89; low birth weight, AOR 0.42, 95% Cl, 0.29-0.61), significantly longer gestations (+7.6 days), higher birth weights (+220 g), lower neonatal morbidity (retinopathy of prematurity, necrotizing enterocolitis, intraventricular hemorrhage, or ventilator support, AOR 0.44, 95% Cl, 0.31-0.62), length of stay (-5.3 days), and cost per twin (-$14,023). Through 3 years of age, program children were significantly less likely to be rehospitalized (AOR 0.31, 95% Cl, 0.11-0.91) or to be developmentally delayed (AOR 0.65, 95% Cl, 0.44-0.96). CONCLUSION: Program participation was associated with improved outcomes at birth and through age 3 years.