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A method for quantifying birthweight discordance in quadruplets and potential use in predicting early mortality
Hamisu M Salihu1, Suparna Bagchi, Sibylle Kristensen
1Department of Obstetrics, Gynecology, and Reproductive Sciences, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, New Jeresy 08901-1977, USA.
American Journal of Perinatology
|April 21, 2006
Summary
Birthweight discordance in quadruplets significantly increases infant mortality risk. This method predicts mortality, accounting for 18-46% of quadruplet deaths in the US.
Area of Science:
- Perinatal Medicine
- Neonatalogy
- Public Health
Background:
- Birthweight discordance is a known risk factor for adverse outcomes in multiple births.
- Quantifying this discordance in quadruplets presents unique challenges.
- Predicting infant mortality in this high-risk population is crucial.
Purpose of the Study:
- To develop and validate a method for quantifying birthweight discordance in quadruplets.
- To assess the association between birthweight discordance and infant, neonatal, and postneonatal mortality.
- To determine the population-attributable risk of mortality due to birthweight discordance in quadruplets.
Main Methods:
- Retrospective cohort study of 2692 quadruplet live births in the US (1995-2000).
- Analysis of gestational age, birthweight, and survival data.
- Calculation of adjusted odds ratios (aOR) and population-attributable risks (PAR).
Main Results:
- Discordance occurred in 26.7% of quadruplet clusters, predominantly with a single discordant infant.
- Birthweight discordance was linked to significantly elevated risks of infant, neonatal, and postneonatal mortality.
- The risk for postneonatal mortality quadrupled after adjusting for small for gestational age.
- Population-attributable risks ranged from 18% to 46% for different infant mortality stages.
Conclusions:
- A novel method effectively quantifies birthweight discordance in quadruplets.
- This discordance is a significant predictor of mortality throughout infancy.
- Birthweight discordance accounts for a substantial proportion of quadruplet infant deaths in the US.
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