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Published on: November 20, 2015
Neonatal morbidity of very low birth weight infants from multiple pregnancies
1Department of Neonatology, Kaplan Medical Center, PO Box 1, Rehovot 76100, Jerusalem, Israel. eric_s@clalit.org.il
Insights
Multiple births increase the risk of very low birth weight infants facing neonatal complications. While twins and singletons show similar early outcomes, very low birth weight triplets and second-born twins face higher mortality and respiratory risks, respectively.
Area of Science:
- Neonatalogy
- Perinatology
- Obstetrics
Background:
- The increasing prevalence of multiple births has led to a rise in very low birth weight (VLBW) infants.
- VLBW infants are susceptible to significant neonatal morbidity and mortality.
- Previous studies comparing outcomes between singletons and multiples have yielded inconsistent results.
Purpose of the Study:
- To compare the neonatal outcomes of singletons, twins, and triplets, focusing on VLBW infants.
- To investigate the specific risks of morbidity and mortality in VLBW multiples.
- To assess the impact of birth order on VLBW twin outcomes.
Main Methods:
- Gestational age-adjusted statistical analysis comparing singleton and multiple birth outcomes.
- Inclusion of confounding variables in comparative analyses.
- Focus on early neonatal morbidity and mortality rates.
Main Results:
- Adjusted comparisons indicate similar early morbidity and mortality risks for VLBW twins and singletons.
- VLBW triplets appear to have a higher risk of neonatal mortality.
- Second-born VLBW twins exhibit increased risk for respiratory morbidity, despite modern therapies.
Conclusions:
- While VLBW twins may have comparable early risks to singletons, VLBW triplets face elevated mortality risks.
- Second-born VLBW twins require vigilant monitoring for respiratory issues, even with advanced neonatal care.
- The findings highlight specific risks associated with different types of multiple births and birth order.
Abstract:
The epidemic of multiple births has translated into a marked rise in very low birth weight infants, who are at risk for major neonatal morbidity and mortality. Gestational age-adjusted comparisons of outcome between singletons and multiples have shown conflicting results. Comparisons that corrected for relevant confounding variables show that twins and singletons have similar risks for early morbidity and mortality. Very low birth weight triplets may have increased risk for neonatal mortality, however. Second-born very low birth weight twins seem to be at risk for increased respiratory morbidity, even in the era of routine antenatal corticosteroids and postnatal surfactant therapy.
