Risk of severe acute maternal morbidity according to gestational age at delivery in twin pregnancies

Objective: To assess the association between gestational age at delivery and postpartum severe acute maternal morbidity (SAMM) in twin pregnancies. Design: Population-based, national, prospective, cohort study Setting: From 02/2014 to 03/2015 in France Population: Women with twin pregnancies who gave birth after 32 weeks of gestation. We excluded women with fetal death or medical termination of either twin, with antepartum SAMM, with antepartum conditions responsible for postpartum SAMM. Methods: Gestational age at delivery was studied as the number of completed weeks of gestation. We assessed the association between gestational age at delivery and postpartum SAMM by using multivariable multilevel modified Poisson regression modelling. Main Outcome Measures: Composite criteria of postpartum severe acute maternal morbidity Results: Among the 7,713 women included, 410 (5.3%) developed postpartum SAMM, mainly (88.5%) postpartum haemorrhage. Compared with the reference category of 37 weeks, the risk of postpartum SAMM was significantly lower for all categories of earlier gestational age at delivery (from aRR=0.34, 95% CI 0.17-0.68 at 32 weeks to aRR=0.71, 95% CI 0.54-0.94 at 36 weeks), and did not differ for later categories. Conclusion: In twin pregnancies, compared with delivery at 37 weeks, delivery at earlier gestational ages is associated with a lower risk of postpartum SAMM. Continuing pregnancy beyond 37 weeks is not associated with an increased risk of postpartum SAMM. Funding: Supported by a grant from the French Ministry of Health (Programme Hospitalier de Recherche Clinique, AOM2012) and a grant from Université Toulouse III. Keywords: severe acute maternal morbidity, twin pregnancy, timing of delivery

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Risk of Severe Acute Maternal Morbidity According to Planned Mode of Delivery in Twin Pregnancies

Obstetrics and Gynecology ◽

10.1097/aog.0000000000002998 ◽

2018 ◽

Vol 132 (6) ◽

pp. 1507

Keyword(s):

Maternal Morbidity ◽

Mode Of Delivery ◽

Severe Acute Maternal Morbidity ◽

Twin Pregnancies

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OC22.03: The association between fetal gender combination in twin pregnancies and gestational age at delivery

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.6582 ◽

2009 ◽

Vol 34 (S1) ◽

pp. 40-41

Author(s):

A. Oldenburg ◽

L. Rode ◽

B. Bødker ◽

V. Ersbak ◽

A. Holmskov ◽

...

Keyword(s):

Gestational Age ◽

Fetal Gender ◽

Gestational Age At Delivery ◽

Twin Pregnancies

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Influence of Gestational Diabetes Mellitus on Weight Discrepancy in Twin Pregnancies

Twin Research and Human Genetics ◽

10.1375/twin.13.4.393 ◽

2010 ◽

Vol 13 (4) ◽

pp. 393-397 ◽

Cited By ~ 7

Author(s):

Katharina Klein ◽

Mariella Mailath-Pokorny ◽

Heinz Leipold ◽

Elisabeth Krampl-Bettelheim ◽

Christof Worda

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Glucose Tolerance ◽

Gestational Diabetes Mellitus ◽

Gestational Age ◽

Relative Weight ◽

Tolerance Test ◽

Oral Glucose ◽

Gestational Age At Delivery ◽

Twin Pregnancies

AbstractObjective:To evaluate the influence of gestational diabetes mellitus on weight discrepancy in twin pregnancies.Methods:200 twin pregnancies were included in the study. 157 nondiabetic pregnant women with twin gestations and 43 twin pregnancies with gestational diabetes mellitus (GDM) with viable fetuses born after 24 weeks of gestation were enrolled. Influence of maternal age, body-mass-index at the time of the oral glucose tolerance test, parity, smoking, chorionicity, gestational age at delivery and diagnosis of GDM on weight discrepancy of the twins was evaluated.Results:Mean weight discrepancy of all analyzed twin pregnancies was 285 grams (± 231), relative weight discrepancy was 11.3% (± 8.6). Univariate regression analyses showed that GDM, chorionicity and gestational age at delivery were significantly associated with weight discrepancy. In the multivariate model only diagnosis of GDM was significantly associated with weight discrepancy.Conclusion:Twin pregnancies with insulin requiring gestational diabetes seem to have less birth weight discrepancy than twin pregnancies with normal glucose tolerance.

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149: Racial disparities in gestational age at delivery among twin pregnancies

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2016.11.053 ◽

2017 ◽

Vol 216 (1) ◽

pp. S100-S101

Author(s):

Jackie Grant ◽

Catherine Vladutiu ◽

Tracy A. Manuck

Keyword(s):

Racial Disparities ◽

Gestational Age ◽

Gestational Age At Delivery ◽

Twin Pregnancies

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Prediction of light-for-gestational age at delivery in twin pregnancies: an evaluation of fetal weight deviation and growth discordance measured by ultrasound

European Journal of Obstetrics & Gynecology and Reproductive Biology ◽

10.1016/0028-2243(92)90151-n ◽

1992 ◽

Vol 47 (3) ◽

pp. 195-200 ◽

Cited By ~ 2

Author(s):

Tine Brink Henriksen ◽

Gerda Elisabeth Villadsen ◽

Morten Hedegaard ◽

Niels J. Secher

Keyword(s):

Gestational Age ◽

Fetal Weight ◽

Gestational Age At Delivery ◽

Twin Pregnancies

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Twin Anemia-Polycythemia Sequence: Perinatal Management and Outcome

Fetal Diagnosis and Therapy ◽

10.1159/000441451 ◽

2015 ◽

Vol 40 (1) ◽

pp. 28-34 ◽

Cited By ~ 8

Author(s):

Eran Ashwal ◽

Yoav Yinon ◽

Michal Fishel-Bartal ◽

Abraham Tsur ◽

Benjamin Chayen ◽

...

Keyword(s):

Gestational Age ◽

Neonatal Morbidity ◽

Control Group ◽

Monochorionic Twins ◽

Monochorionic Twin ◽

Gestational Age At Delivery ◽

Perinatal Management ◽

Intrauterine Blood Transfusion ◽

And Control ◽

Twin Pregnancies

Objective: To determine the perinatal outcome of monochorionic twin pregnancies complicated by twin anemia-polycythemia sequence (TAPS). Methods: All monochorionic twins diagnosed with TAPS between 2011 and 2014 were included. Each twin pair with TAPS (study group) was compared with 2 uncomplicated monochorionic twin pairs who were matched for gestational age at delivery (control group). Neonatal morbidity and mortality were evaluated. Results: During the study period, 179 monochorionic twins were followed at our center, of whom 46 underwent laser ablation due to twin-to-twin transfusion syndrome. TAPS was diagnosed in 10 cases; 8 of them were spontaneous, and 2 occurred following laser surgery. Out of 7 patients diagnosed prenatally with TAPS, 5 cases were managed expectantly, and 2 cases were treated with intrauterine blood transfusion. The rates of severe and mild central nervous system lesions on postnatal ultrasound were similar in the TAPS group and control group (5.0 vs. 2.5%, p = 0.61, and 5.0 vs. 12.5%, p = 0.25, respectively). Additionally, severe neonatal morbidity was comparable between the groups. All neonates were alive at 1 month of age. Conclusion: The neonatal outcome of monocohorionic twins affected by TAPS is favorable and comparable to gestational age-matched uncomplicated monochorionic twins.

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