Twins vs singletons-Long-term health outcomes

Area of Science:

• Obstetrics and Gynecology
• Pediatrics
• Public Health

Background:

• Multiple gestations, particularly twin pregnancies, are associated with increased risks for various pregnancy complications.
• Understanding the long-term health implications for offspring born from twin pregnancies is crucial for pediatric and obstetric care.

Purpose of the Study:

• To investigate whether offspring born after twin pregnancies are at an increased risk for long-term health complications compared to singleton offspring.
• To analyze the incidence and types of hospital-based morbidities in twins versus singletons up to 18 years of age.

Main Methods:

• A retrospective cohort study included over 369,000 offspring born between 1991-2021, followed until age 18.
• Hospital diagnoses were categorized into cardiac, respiratory, infectious, neurological, malignancy, and metabolic morbidities.
• Cox proportional hazard models were used to compare hospitalization risks between twins and singletons, adjusting for maternal factors.

Main Results:

• Twins (3.2%) were more likely to be born preterm, via Cesarean, and after infertility treatments compared to singletons (96.8%).
• Incidence of hospitalizations for cardiac, respiratory, infectious, and malignancy groups was significantly higher in twins.
• Multivariable analyses confirmed a higher risk for most morbidities in twins (adjusted hazard ratios 1.09-1.75).

Conclusions:

• Twins exhibit an elevated risk for most morbidities, primarily attributed to their higher rates of preterm birth.
• When gestational age at delivery is similar, the risk for most morbidities is lower among twins compared to singletons.