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Mortality of twin and singleton livebirths under 30 weeks’ gestation: a population-based study
  1. B Ray1,
  2. M P Ward Platt2
  1. 1
    Royal Victoria Infirmary, Newcastle upon Tyne, UK
  2. 2
    Newcastle University, Newcastle upon Tyne, UK
  1. M P Ward Platt, Newcastle University, Newcastle upon Tyne, UK; m.p.ward-platt{at}


Objective: To determine the mortality rates of liveborn twins compared with singletons of less than 30 weeks’ gestation in relation to gestational age, mode of delivery and year of birth in a geographically defined population.

Study design: Comparison of early neonatal, late neonatal and infant death rates in 479 twin babies and 1538 singletons, liveborn between 23 and 29 completed weeks of gestation in the north of England over two epochs, 1998–2001 and 2002–5.

Results: Twins and singletons had similar mortality rates except at the extreme of gestation (23–25 weeks) where twins had higher infant mortality (OR 2.04, 95% CI 1.37 to 3.02). This higher rate was attributable to early and late neonatal deaths (OR 1.86, 95% CI 1.28 to 2.72, and 2.11, 95% CI 1.13–3.94, respectively). When analysed in two epochs, the excess mortality was confined to babies born in 1998–2001. There was no effect of gender or chorionicity.

Conclusions: The excess mortality among twins of less than 30 weeks’ gestation was confined to neonatal deaths in babies of 25 weeks or less, and to the earlier epoch (1998–2001). In the modern era, there appears to be no excess mortality in neonates less than 30 weeks’ gestation when compared with singletons.

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  • Funding: Funding for the Northern Congenital Abnomality Survey is provided by the Department of Health.

  • Competing interests: None.

  • Ethics approval: The registers used in this study have been approved by ethics committees.

  • Patient consent: We used the Multiple Pregnancy Register and data from the Perinatal Morbidity and Mortality Survey. The registers have clearance from the Patient Information Advisory Group (PIAG) to hold named patient information without individual consent under section 60 of the Health and Social Care Act (2001).