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Prevalence of cerebral palsy in twins, triplets and quadruplets
Y Yokoyama1, T Shimizu, K Hayakawa
1Department of Public Health, Kinki University School of Medicine, Osaka, Japan.
Insights
The risk of cerebral palsy increases with higher-order multiple births. Premature birth and asphyxia are key factors contributing to cerebral palsy in twins, triplets, and quadruplets.
Area of Science:
- Obstetrics and Gynecology
- Pediatrics
- Neurology
Background:
- Multiple births, including twins, triplets, and quadruplets, are associated with a higher incidence of cerebral palsy compared to singleton births.
- Understanding the specific risks and contributing factors in higher-order multiple births is crucial for improved neonatal care.
Purpose of the Study:
- To investigate the prevalence and risk of cerebral palsy in twins, triplets, and quadruplets.
- To identify specific factors associated with the increased risk of cerebral palsy in these populations.
Main Methods:
- Data were collected from the Kinki University Twin and Higher Order Multiple Births Registry.
- The study analyzed birth and health records of twins, triplets, and quadruplets born after 1977.
- Logistic regression was used to adjust for associated factors and identify significant risk predictors.
Main Results:
- Prevalence of cerebral palsy was 0.9% in twins, 3.1% in triplets, and 11.1% in quadruplets.
- The risk of at least one child having cerebral palsy was 1.5% for twins, 8.0% for triplets, and 42.9% for quadruplets.
- Decreased gestational age (especially < 32 weeks) and asphyxia were significantly associated with increased cerebral palsy risk, with premature infants being 20 times more likely to develop the condition.
Conclusions:
- Cerebral palsy prevalence is notably higher in triplets and quadruplets than in twins.
- Lower gestational age is a critical factor linked to a greater risk of developing cerebral palsy in multiple births.
Background:
Twins and triplets are at higher risk of cerebral palsy than singletons. This study investigated the degree of risk for cerebral palsy in twins, triplets and quadruplets, and identified factors associated with the increased risk.
Methods:
The subjects were recruited from the Kinki University Twin and Higher Order Multiple Births Registry.
Results:
The subjects were 705 twins pairs (1410 twins), 96 sets of triplets (287 triplets excluding one infant death), and 7 sets of quadruplets (27 quadruplets excluding one infant death), who were born after 1977. The prevalence of cerebral palsy was 0.9% among 1410 twins, 3.1% among 287 triplets, and 11.1% among 27 quadruplets. Furthermore, the risks of producing at least one child with cerebral palsy were 1.5%, 8.0%, 42.9% in twin, triplet, quadruplet pregnancies, respectively. After adjusting for each associated factor using logistic regression, the risk of cerebral palsy was significantly associated with decrease in gestational age and asphyxia. The odds ratio indicated that infants whose gestational age was < 32 weeks were 20 times more likely to develop cerebral palsy than infants whose gestational age was > or = 36 weeks.
Conclusions:
The prevalence of cerebral palsy in triplets and quadruplets was higher than that in twins. Lower gestational age was associated with a greater risk of cerebral palsy.