Late prematurity in twins: a Polish multicenter study.

Area of Science:

• Neonatology
• Obstetrics
• Perinatology

Background:

• Late prematurity (LPT) is defined as birth between 34 and 36 completed weeks of gestation.
• Twins represent a significant proportion of late preterm births, often facing distinct neonatal challenges.
• Understanding LPT's impact on twin neonatal outcomes is crucial for targeted interventions.

Purpose of the Study:

• To investigate the impact of late prematurity on neonatal outcomes in twins.
• To analyze neonatal morbidity and mortality rates in late preterm twins based on gestational age.
• To identify key factors influencing neonatal complications in late preterm twins.

Main Methods:

• A comparative analysis of 465 twin deliveries across six Polish tertiary centers in 2012.
• Comparison between late preterm (34+0-36+6 weeks) and term (≥37 weeks) twin groups.
• Assessment of maternal factors, pregnancy course, delivery, and short-term neonatal morbidities, including respiratory disorders, jaundice, and NICU admissions.

Main Results:

• No neonatal deaths were recorded in either late preterm or term twin groups.
• One-third of late preterm twins experienced respiratory issues or required antibiotics; 40% had jaundice, and 30% were admitted to the NICU.
• Neonatal morbidity decreased with advancing gestational age, particularly respiratory disorders and NICU admissions. Neonatal birth weight (OR=0.43) and gestational age (OR=0.62) were significant factors.

Conclusions:

• Late prematurity significantly increases the risk of neonatal morbidity in twins compared to term twins.
• Gestational age at delivery and neonatal birth weight are critical determinants of neonatal outcomes in twins.
• While LPT twins face higher morbidity, careful monitoring and management based on gestational age and weight can optimize outcomes.