Neonatal outcome of very premature infants from multiple and singleton gestations☆,☆☆,★,★★
Section snippets
Methods
The study is a retrospective evaluation of the neonatal outcome of all live-born infants of 24 to 32 weeks' gestation born at New England Medical Center from July 1, 1992, through Dec. 31, 1994. All deliveries were performed by the high-risk perinatology team at NEMC. The large majority of these deliveries were maternal referrals to the perinatology service from outlying hospitals. The gestational age used for this study was that which was assigned by the attending perinatologist at NEMC, with
Results
We were able to obtain data on all 572 infants born at NEMC and admitted to the NICU within the 30-month study period. Of these, 369 infants came from singleton pregnancies and 203 infants came from multiple gestations (subsequently referred to as multiples). The multiples were from 73 twin pregnancies, 18 triplet pregnancies, and 2 quadruplet pregnancies. Overall, there were 61, 112, and 196 singletons, and 39, 57, and 107 multiples in the categories of 24 to 26, 27 to 29, and 30 to 32 weeks,
Comment
It is well established that pregnancies carrying more than one fetus are more likely to be complicated.1, 2, 3, 4, 6 This study was performed to address the question of whether very premature live-born infants from multiple gestations had outcomes similar to those of premature singleton live-born infants. Although the neonatal outcome of multiple gestations has been described in several studies over the past 25 years, this study has important design and population features in comparison with
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2010, Seminars in Fetal and Neonatal MedicineCitation Excerpt :No differences persisted in the incidences of most neonatal complications, and the multiples achieved most milestones at the same time as the singletons. Nielson et al.5 collected data on 572 very preterm infants of whom 203 were from multiple gestations. The results were compared in gestation categories.
Clinical issues in the management of late preterm infants
2010, Current Problems in Pediatric and Adolescent Health CareCitation Excerpt :Additionally, in the USA the mean age at delivery for twins was 35.3 weeks, 32.2 weeks for triplets, and 29.9 weeks for quadruplets compared with 38.8 weeks for singletons.19 Although the offspring of a multiple gestation may be born earlier than singletons, preterm twin and triplet neonates appear to have similar birth weight, morbidity, and mortality as singleton controls of the same gestational age.20,21 Most twins and many high-order multiples deliver in the late preterm period because of either spontaneous preterm labor or iatrogenic interventions intended to treat maternal and fetal medical complications.
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From the Division of Neonatology, Department of Pediatrics, the Floating Hospital for Infants and Children at New England Medical Center.
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Supported by grant HL-37930 from the National Institutes of Health.
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Reprint requests: Heber C. Nielsen, MD, Division of Newborn Medicine, NEMC 97, Tufts New England Medical Center, 750 Washington St., Boston, MA 02111.
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0002-9378/97 $5.00 + 0 6/1/82740