Morbidity and mortality of preterm twins and higher-order multiple births

被引：24

作者：

Suri K. ^{[1
]}

Bhandari V. ^{[2
]}

Lerer T. ^{[3
]}

Rosenkrantz T.S. ^{[1
]}

Hussain N. ^{[1
]}

机构：

[1] Department of Pediatrics, Division of Neonatology, University of Connecticut School of Medicine, Farmington, CT

[2] Department of Pediatrics, Division of Neonatology, Albert Einstein Medical Center, Philadelphia, PA

[3] Office of Research, Connecticut Children's Medical Center, Hartford, CT

来源：

Journal of Perinatology | 2001年 / 21卷 / 5期

关键词：

D O I：

10.1038/sj.jp.7200492

中图分类号：

学科分类号：

摘要：

Objective: To determine if preterm infants of higher-order multiple (HOM) gestations have a significantly worse outcome during hospital stay when compared with preterm twins. Study Design: Retrospective cohort analysis. Methods: Perinatal outcome variables including gestational age (GA), birthweight, prenatal steroid use, cesarean section delivery rate, Apgar scores, and growth retardation were analyzed for 106 preterm HOM births (triplets and quadruplets) versus 328 preterm twins admitted to a single tertiary level neonatal intensive care unit. A comparison of the mortality and major neonatal morbidities such as respiratory distress syndrome, patent ductus arteriosus, intraventricular hemorrhage, necrotizing enterocolitis, bronchopulmonary dysplasia, and retinopathy of prematurity was made for these two groups. In addition, the duration of respiratory support including surfactant therapy, nasal continuous positive airway pressure, and mechanical ventilation, as well as the length of hospitalization, was analyzed. Results: There were no significant differences in major morbidities between the infants of HOM and twin births of similar GA. There was no statistically significant difference in mortality, but the data showed a trend for lesser mortality in HOM. There was a highly significant increase in antenatal steroid use as well as the use of cesarean section for delivery in the HOM when compared with twin gestations. The infants of HOM gestations were of significantly lower birthweight than the twins and had a longer hospitalization. Conclusion: Although premature infants of HOM had lower birthweight and needed a longer hospital stay, their mortality and morbidity at hospital discharge were not worse than that for preterm twins.

引用

页码：293 / 299

页数：6

共 34 条

[1]

Loucopoulos A., Jewelewicz R., Management of multifetal pregnancies: Sixteen years' experience at the Sloan Hospital for Women, Am J Obstet Gynecol, 143, pp. 902-905, (1982)

[2]

Ron-El R., Caspi E., Schreyer P., Weinraub Z., Arieli S., Goldberg M.D., Triplet and quadruplet pregnancies and management, Obstet Gynecol, 57, pp. 458-463, (1981)

[3]

Martin J.A., MacDorman M.F., Mathews T.J., Triplet births: Trends and outcomes 1971-94, Vital Health Stat, 21, pp. 1-20, (1997)

[4]

Luke B., Keith L.G., The contribution of singletons, twins and triplets to low birth weight, infant mortality and handicap in the United States, J Reprod Med, 37, pp. 661-666, (1992)

[5]

Holcberg G., Biale Y., Lewenthal H., Insler V., Outcome of pregnancy in 31 triplet gestations, Obstet Gynecol, 59, pp. 472-476, (1982)

[6]

Olofsson P., Triplet and quadruplet pregnancies - A forthcoming challenge also for the "general" obstetrician, Eur J Obstet Gynecol Reprod Biol, 35, pp. 159-171, (1990)

[7]

Melgar C.A., Rosenfeld D.L., Rawlinson K., Greenberg M., Perinatal outcome after multifetal reduction to twins compared with nonreduced multiple gestations, Obstet Gynecol, 78, pp. 763-767, (1991)

[8]

Boulot P., Hedon B., Pelliccia G., Et al., Obstetrical results after embryonic reductions performed on 34 multiple pregnancies, Hum Reprod, 5, pp. 1009-1013, (1990)

[9]

Angel J.L., Kalter C.S., Morales W.J., Rasmussen C., Caron L., Aggressive perinatal care for high-order multiple gestations: Does good perinatal outcome justify aggressive assisted reproductive techniques?, Am J Obstet Gynecol, 181, pp. 253-259, (1999)

[10]

Skrablin S., Kuvacic I., Pavicic D., Kalafatic D., Goluza T., Maternal neonatal outcome in quadruplet and quintuplet versus triplet gestations, Eur J Obstet Gynecol Reprod Biol, 88, pp. 147-152, (2000)

← 1 2 3 4 →