Gestational age, morbidity and mortality among twin births in New South Wales, Australia 2003-2014: A cohort study.
Aust N Z J Obstet Gynaecol
; 60(4): 541-547, 2020 08.
Article
em En
| MEDLINE
| ID: mdl-31782140
ABSTRACT
BACKGROUND:
Evidence suggests that the trend toward early planned births observed among singletons may be evident among twin pregnancies.AIMS:
To describe trends in gestational age at birth, pregnancy characteristics, neonatal morbidity and mortality among twin pregnancies. MATERIALS ANDMETHODS:
Population-based data linkage study of twin births of ≥30 weeks of gestation without a major congenital anomaly born in 2003-2014 in New South Wales (NSW), Australia. Linked pregnancy and birth, hospital and mortality data were used. Generalised linear regression was used to assess linear trends. Risk difference (RD) and 95% confidence intervals were estimated.RESULTS:
Among 28 076 eligible twin births (14 038 pregnancies), 49% of births occurred prior to 37 weeks and 69% of births were planned (pre-labour caesarean or induction of labour). There were increases over time in the proportion of twin births at preterm gestations (30-34 weeks (RD 2.1, 95% CI 0.1, 4.0), 35-36 weeks (RD 7.5, 95% CI 5.4, 9.7)) and in the rates of planned births (pre-labour caesarean (RD 6.4, 95% CI 4.0, 8.8), induction (RD 4.6, 95% CI 2.6, 6.6)). There was no significant change in stillbirth or neonatal death rates, but there was an increase in neonatal morbidity over the study period. Concurrently, there were increases in the prevalence of gestational diabetes; and decreases in pregnancy hypertension, assisted reproductive technology use, small-for-gestational age and birthweight discordance.CONCLUSIONS:
Gestational age at birth among twin births is decreasing and birth intervention is increasing. There are increasing rates of neonatal morbidity, but no overall change in perinatal mortality.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Gravidez de Gêmeos
Tipo de estudo:
Etiology_studies
/
Incidence_studies
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Observational_studies
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Risk_factors_studies
Limite:
Female
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Humans
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Infant
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Newborn
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Pregnancy
País/Região como assunto:
Oceania
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article