Hostname: page-component-848d4c4894-wzw2p Total loading time: 0 Render date: 2024-06-08T01:02:28.563Z Has data issue: false hasContentIssue false
  • English
  • Français

Reducing Fetal Deaths in Multiple Births: Optimal Birthweights and Gestational Ages for Infants of Twin and Triplet Births*

Published online by Cambridge University Press:  01 August 2014

B. Luke
B. Luke*
Affiliation:
Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, Michigan, USA
*
Department of Obstetrics and Gynecology, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, Michigan 48109-0264, USA

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

The objective of this study was to determine the birthweight and gestational age associated with the lowest fetal mortality for twins and triplets. The study design was a population-based analysis of all live births and fetal deaths in the US between 1983-88. Fetal mortality was compared by categories of birthweight and gestational age, for twins and triplets versus singletons, and within each plurality by the lowest rate compared to all other rates as relative risks ± 95% Cls. The overall versus lowest fetal death rate per 1,000 conceptions for singletons was 4.3 versus 0.9 at 3700-4000 g and 40-41 weeks; for twins, 15.5 versus 3.3 at 2500-2800 g and 36-37 weeks; and for triplets, 21.0 versus 5.2 at 1900-2200 g at 34-35 weeks. Beyond these plurality-specific lowest ranges, the risk of fetal death increased, more for twins than singletons, and most for triplets. To conclude, fetal death rates can be reduced by 75-80% with attainment of birthweight and gestational age within a plurality-specific ideal range.

Keywords

Fetal deathIUGRTwinsTriplets
Type
Research Article
Information
Acta geneticae medicae et gemellologiae: twin research , Volume 45 , Issue 3 , July 1996 , pp. 333 - 348
Copyright
Copyright © The International Society for Twin Studies 1996

Footnotes

*

Presented at the 16th Annual Meeting of the Society of Perinatal Obstetricians, Kona, Hawaii, February, 1996.

References

REFERENCES

1.Brown, JE, Schloesser, PT (1990): Prepregnancy weight status, prenatal weight gain, and the outcome of term twin gestations. Am J Obstet Gynecol 162: 182–186.CrossRefGoogle ScholarPubMed
2.Cherouny, PH, Hoskins, IA, Johnson, TRB, Niebyl, JR (1989): Multiple pregnancy with late death of one fetus. Obstet Gynecol 74: 318–320.Google Scholar
3.Crowther, CA, Verkuyl, DM, Ashworth, MF, Bannerman, C, Ashurst, HM (1991): The effects of hospitalization for bed rest on duration of gestation, fetal growth, and neonatal morbidity in triplet pregnancy. Acta Genet Med Gemellol 40: 63–68.Google ScholarPubMed
4.David, RJ (1980): The quality and completeness of birthweight and gestational age data in computerized birth files. Am J Public Health 70: 964–973.CrossRefGoogle ScholarPubMed
5.Elster, AD, Bleyl, JL, Craven, TE (1991): Birth weight standards for triplets under modern obstetric care in the United States, 1984-1989. Obstet Gynecol 77: 387–393.Google ScholarPubMed
6.Food and Nutrition Board. Nutrition During Pregnancy. Washington, DC: National Academy of Science, 1990.Google Scholar
7.Kiely, JL, Kleinman, JC, Kiely, M (1992): Triplets and higher-order multiple births. Am J Dis Child 146: 862–868.CrossRefGoogle ScholarPubMed
8.Kilpatrick, SJ, Jackson, R, Croughan-Minihane, MS (1996): Perinatal mortality in twins and singletons matched for gestational age at delivery at >30 weeks. Am J Obstet Gynecol 174: 66–71.CrossRefGoogle Scholar
9.Kovacs, BW, Kirschbaum, TH, Paul, RH (1989): Twin gestations: I. Antenatal care and complications. Obstet Gynecol 74: 313–317.Google ScholarPubMed
10.Leveno, KJ, Quirk, JG, Whalley, PJ, Herbert, WN, Trubey, R (1984): Fetal lung maturation in twin gestation. Am J Obstet Gynecol 148: 405–411.CrossRefGoogle ScholarPubMed
11.Luke, B, Minogue, J, Abbey, H (1992): The association between maternal weight gain and the birthweight of twins. J Maternal-Fetal Med 1: 267–276.CrossRefGoogle Scholar
12.Luke, B, Minogue, J, Witter, FR (1993): The role of fetal growth restriction and gestational age on length of hospital stay in twin infants. Obstet Gynecol 81: 949–953.Google Scholar
13.Luke, B, Minogue, J, Witter, FR, Keith, LG, Johnson, TRB (1993): The ideal twin pregnancy: Patterns of weight gain, discordancy, and length of gestation. Am J Obstet Gynecol 169: 588–597.CrossRefGoogle ScholarPubMed
14.Luke, B (1994): The changing pattern of multiple births in the United States: Maternal and infant characteristics, 1973 and 1990. Obstet Gynecol 84: 101–106.Google ScholarPubMed
15.Luke, B, Minogue, J (1994): Contribution of gestational age and birth weight to perinatal viability in singletons versus twins. J Maternal-Fetal Med 3: 263–274.Google Scholar
16.Luke, B, Bryan, E, Sweetland, C, Leurgans, S, Keith, L (1995): Prenatal weight gain and the birth-weight of triplets. Acta Genet Med Gemellol 44: 93–101.Google ScholarPubMed
17.Luke, B, Leurgans, S (1996): Maternal weight gains in ideal twin outcomes. J Am Dietet Assoc 96: 178–181.CrossRefGoogle ScholarPubMed
18.Luke, B, Bigger, H, Leurgans, S, Sietsema, D (1996): The cost of prematurity: A case-control study of twins versus singletons. Am J Public Health 86: 809–814.CrossRefGoogle Scholar
19.Pederson, AL, Worthington-Robert, B, Hickok, DE (1989): Weight gain patterns during twin gestation. J Am Dietet Assoc 89: 642–646.CrossRefGoogle ScholarPubMed
20.Piper, JM, Xenakis, E M-J, McFarland, M, Elliott, BD, Berkus, MD, Langer, O (1996): Do growth-retarded premature infants have different rates of perinatal morbidity and mortality than appropriately grown premature infants? Obstet Gynecol 87: 169–174.Google Scholar
21.Rhydstrom, H, Nordenskold, F, Grennert, L, Ohrlander, S, Aberg, A (1987): Routine hospital care does not improve prognosis in twin gestation. Acta Obstet Gynecol Scand 66: 361–364.Google Scholar
22.Seoud, MAF, Toner, JP, Kruithoff, C, Muasher, SJ (1992): Outcome of twin, triple, and quadruplet in vitro fertilization pregnancies: the Norfolk experience. Fertil Steril 57: 825–834.Google Scholar
23.Society for Assisted Reproductive Technology. Assisted reproductive technology in the United States and Canada (1993): 1991 results from the Society for Assisted Reproductive Technology generated from the American Fertility Society Registry. Fertil Steril 59:956–962.Google Scholar
24.US Department of Health, Education, and Welfare. Vital Statistics of the United States, 1970. Vol. I, Natality. HRA Pub. No. 75-1100. Rockville, MD, 1975.Google Scholar
25.US Department of Health and Human Services, Public Health Service. Vital Statistics of the United States, 1985. Vol. I, Natality. Hyattsville, MD, 1988.Google Scholar
26.Ventura, SJ, Martin, JA, Taffel, SM, Advance report of final natality statistics, 1994. Monthly vital statistics report. Vol. 44, No. II, Suppl. Hyattsville, MD: National Center for Health Statistics, 1996.Google Scholar
27.Wilcox, AJ, Skjoerven, R (1992): Birth weight and perinatal mortality: The effect of gestational age. Am J Public Health 82: 378–382.CrossRefGoogle ScholarPubMed
28.Wilcox, LS, Mosher, WD (1993): Use of infertility services in the United States. Obstet Gynecol 82: 122–127.Google Scholar
29.Wolf, EJ, Vintzileos, AM, Rosenkrantz, TS, Rodis, JF, Lettieri, L, Mallozzi, A (1992): A comparison of pre-discharge survival and morbidity in singleton and twin very low birth weight infants. Obstet Gynecol 80: 436–439.Google Scholar
30.Zhang, J, Bowes, WA (1995): Birth-weight-for-gestational-age patterns by race, sex, and parity in the United States population. Obstet Gynecoh 86: 200–208.Google Scholar