Gestational Duration, and Fetal and Infant Mortality for Twins vs Singletons

Twin Research ◽  
2001 ◽  
Vol 4 (4) ◽  
pp. 227-231 ◽  
Author(s):  
Hakan Rydhstroem ◽  
Fayez Heraib
Keyword(s):  
Infant Mortality ◽  
Risk Evaluation ◽  
Preterm Births ◽  
Fetal Mortality ◽  
Birth Registry ◽  
National Board ◽  
High Incidence ◽  
Delivery Unit ◽  
Twin Pregnancies ◽  
Gestational Duration

AbstractThe aim of this research was to study fetal and infant mortality in Sweden between 1973 and 1996 in twins vs singletons in relation to gestational duration. Analysis was of fetal and infant mortality based on the number of pregnancies at risk as the denominator rather than the number of deliveries each week. The analysis was based on information stored at the Medical Birth Registry (MBR), the National Board of Health and Welfare, Stockholm. The MBR keeps records on virtually all pregnancies (> 99%) regarding delivery and neonatal information, and for infant mortality up to 1 year of age. During the study period, 2,206,738 singleton and 52,658 twin births were registered. Risk evaluation was made as odds ratio (OR) with a 95% confidence interval. The material was stratified according to parity, maternal age, year of delivery, and delivery unit. Results showed the OR for twin births before 34 weeks gestation was 6 to 8-fold increased compared with singletons. The OR for fetal mortality was increased in all gestational weeks, and like-sexed twins had a consistently poorer prognosis compared to unlike-sexed. Between 1989–96, unlike-sexed twins had a fetal mortality approaching that of singletons. In conclusion, real progress in reduction of infant mortality in twins may be impossible until the high incidence of preterm births can be decreased. Hypothetically, about 100 twin labors would have to be induced to avoid one fetal death in like-sexed twin pregnancies.

Time Trends in Characteristics and Outcome of Twin Pregnancies

1991 ◽  
Vol 40 (2) ◽  
pp. 181-192 ◽  
Author(s):  
L. Moreault ◽  
S. Marcoux ◽  
J. Fabia ◽  
S. Tennina
Keyword(s):  
Mortality Rate ◽  
Neonatal Mortality ◽  
Low Birthweight ◽  
Preterm Births ◽  
Mortality Rates ◽  
Fetal Mortality ◽  
Neonatal Mortality Rate ◽  
Risk Of Death ◽  
Twin Pregnancies ◽  
Over Time

AbstractThis study describes the evolution in fetal and neonatal mortality rates among twin pairs born in 22 hospitals located in the eastern regions of the province of Quebec in 1976-1978 (n = 776 pairs) and 1982-1985 (n = 712 pairs). It also assesses the contribution of maternal factors, obstetrical care and characteristics of twins in the variation of the risk of death over time. The fetal mortality rate did not improve from 1976-1978 (22.6 per 1000) to 1982-1985 (28.1 per 1000). However, the neonatal mortality rate declined from 44.7 to 34.7 per 1000 liveborn first twins and from 56.8 to 36.1 per 1000 liveborn second twins. For first twins as for second twins, birthweight-specific neonatal mortality rates decreased within birth weight categories under 2500 g. In the second period, 96.9% of twin pregnancies were detected before confinement compared to 59.6% in the earlier period. The proportion of twins delivered by obstetricians, the percentage of twin births occurring in ultraspecialized perinatal units and the frequency of caesarean sections increased markedly. The proportion of preterm births increased over time (34.5% vs 43.1%) whereas the percentage of low birthweight twins decreased but not significantly (54.3% 51.6%). In this study, changes in maternal age, parity, educational level, sex of pairs, qualification of the physician, and level of care available at the hospital of birth, did not account for the decrease in neonatal mortality rates among twins. The increase in the frequency of caesarean sections seemed to explain only a small proportion of the decrease in the neonatal mortality rate among second twins. In the second as well as in the first period, the neonatal mortality rate for twins was six times higher than that for singletons.

Prediction of Spontaneous Preterm Delivery in Twin Pregnancies By Cervical Length at Mid-Gestation

2008 ◽  
Vol 11 (5) ◽  
pp. 552-557 ◽  
Author(s):  
Katharina Klein ◽  
Hubertus Gregor ◽  
Kora Hirtenlehner-Ferber ◽  
Maria Stammler-Safar ◽  
Armin Witt ◽  
...  
Keyword(s):  
Preterm Delivery ◽  
Smoking Habit ◽  
Cervical Length ◽  
Spontaneous Preterm Delivery ◽  
Spontaneous Labour ◽  
High Incidence ◽  
High Cervical ◽  
Twin Pregnancies ◽  
Preterm Rupture Of Membranes ◽  
Spontaneous Delivery

AbstractThe objective of our study was to evaluate the correlation of the cervical length at 20–25 weeks of gestation with the incidence of spontaneous preterm delivery in twins in a country with a high incidence of preterm delivery compared to other European countries. Cervical length was measured in 262 consecutive patients. Previous preterm delivery before 34 weeks of gestation, chorionicity, maternal age, body-mass-index, smoking habit and parity were recorded as risk factors for preterm delivery. Women who were symptomatic at 20–25 weeks and who delivered because of other reasons than spontaneous labour and preterm rupture of membranes or at term were excluded. The primary outcome was incidence of preterm birth before 34 weeks. Two hundred and twenty-three patients were analyzed. Thirty-two (14%) delivered before 34 weeks. There was a significant correlation between cervical length of less than 25 mm and spontaneous delivery before 34 weeks (50% vs. 13%,p= .007). In addition, logistic regression analysis found cervical length to be the only significant predictor of spontaneous delivery before 34 weeks (OR 1.084; 95% CI 1.015; 1.159;p= .017). We conclude that the risk of severe preterm delivery in twins is high. Cervical length at mid-gestation was the only predictor of delivery before 34 weeks.

Perinatal Profile of Twin Pregnancies: A Retrospective Review of 11 Years (1969–1979) at Hôpital Notre-Dame, Montréal, Canada

1982 ◽  
Vol 31 (3-4) ◽  
pp. 157-163 ◽  
Author(s):  
Marie-Françoise Desgranges ◽  
Xavier De Muylder ◽  
Jean-Marie Moutquin ◽  
Francisco Lazaro-Lopez ◽  
Bernard Leduc
Keyword(s):  
Perinatal Mortality ◽  
Perinatal Care ◽  
Fetal Mortality ◽  
Ultrasound Technique ◽  
Intrauterine Growth ◽  
Before And After ◽  
The Impact ◽  
Second Period ◽  
Twin Pregnancies ◽  
Main Factor

Four hundred and thirty four twins occurring in 220 women were studied during a period of 11 years (1969–1979) at Notre-Dame Hospital.Perinatal mortality (< 28 days) was compared before and after 1974, and the impact of ultrasound technique upon perinatal outcome was assessed during the second period (1974–1979). The main factor associated with perinatal mortality was low birth weight caused by either prematurity or intrauterine growth retardation.While fetal mortality remained unchanged within the two study periods, neonatal mortality decreased from 68.2/1,000 to 28.9/1,000 mainly due to increased survival rate of twins below 1,500 g at birth.With identical perinatal care during the same period, perinatal mortality and incidence of intrauterine growth-retarded twins remained unchanged despite early diagnosis by ultrasound.

scholarly journals Effects of Randomized Corruption Audits on Early-Life Mortality in Brazil

2020 ◽  
Author(s):  
Antonio Pedro Ramos ◽  
Robert Weiss ◽  
Simeon Nietcher ◽  
Leiwen Gao
Keyword(s):  
Health Disparities ◽  
Infant Mortality ◽  
Health Outcomes ◽  
Neonatal Mortality ◽  
Child Mortality ◽  
Early Life ◽  
Causal Effect ◽  
Preterm Births ◽  
The Impact ◽  
Improve Health

Background: Various studies suggest that corruption affects public health systems across the world. However, the extant literature lacks causal evidence about whether anti-corruption interventions can improve health outcomes. We examine the impact of randomized anti-corruption audits on early-life mortality in Brazil. Methods: The Brazilian government conducted audits in 1,949 randomly selected municipalities between 2003 and 2015. To identify the causal effect of anti-corruption audits on early-life mortality, we analyse data on health outcomes from individual- level vital statistics (DATASUS) collected by Brazil government before and after the random audits. Data on the audit intervention are from the Controladoria-Geral da Uniao, the government agency responsible for the anti-corruption audits. Outcomes are neonatal mortality, infant mortality, child mortality, preterm births, and prenatal visits. Analyses examine aggregate effects for each outcome, as well as effects by race, cause of death, and years since the intervention. Results: Anti-corruption audits significantly decreased early-life mortality in Brazil. Expressed in relative terms, audits reduced neonatal mortality by 6.7% (95% CI -8.3%, -5.0%), reduced infant mortality by 7.3% (-8.6%, -5.9%), and reduced child mortality by 7.3% (-8.5%, -6.0%). This reduction in early mortality was higher for nonwhite Brazilians, who face significant health disparities. Effects are greater when we look at deaths from preventable causes, and show temporal persistence with large effects even a decade after audits. In addition, analyses show that the intervention led to a 12.1% (-13.4%, -10.6%) reduction in women receiving no prenatal care, as well as a 7.4% (-9.4%, -5.5%) reduction in preterm births; these effects are likewise higher for nonwhites and are persistent over time. All effects are robust to various alternative specifications. Interpretation: Governments have the potential to improve health outcomes through anti-corruption interventions. Such interventions can reduce early-life mortality and mitigate health disparities. The impact of anti-corruption audits should be investigated in other countries, and further research should further explore the mechanisms by which combating corruption affects the health sector.

scholarly journals Increasing Knowledge and Health Literacy about Preterm Births in Underserved Communities: An Approach to Decrease Health Disparities, a Pilot Study

2015 ◽  
Vol 8 (1) ◽  
pp. 83 ◽  
Author(s):  
Allison A. Vanderbilt ◽  
Marcie S. Wright ◽  
Alisa E. Brewer ◽  
Lydia K. Murithi ◽  
PonJola Coney
Keyword(s):  
Health Disparities ◽  
Preterm Birth ◽  
Health Literacy ◽  
Pilot Study ◽  
Health Knowledge ◽  
Preterm Births ◽  
Fetal Mortality ◽  
Provider Communication ◽  
Underserved Communities ◽  
Metro Area

<p><strong>INTRODUCTION:</strong> Health disparities can negatively impact subsets of the population who have systematically experienced greater socioeconomic obstacles to health. For example, health disparities between ethnic and racial groups continue to grow due to the widening gap in large declines in infant and fetal mortality among Caucasians compared to Black non-Hispanic or African Americans. According to the American Congress of Obstetricians and Gynecologists, preterm birth remains a leading cause of infant morbidity and mortality. The purpose of our study is to determine if the computer-based educational modules related to preterm birth health literacy and health disparity with a pre-test and post-test can effectively increase health knowledge of our participants in targeted underserved communities within the Richmond-metro area.</p> <p><strong>METHODS:</strong> This was a pilot study in the Richmond-Metro area. Participants were required to be over the age of 18, and had to electronically give consent. Descriptive statistics, means and standard deviations, and Paired <em>t-</em>tests were conducted in SPSS 22.0.</p> <p><strong>RESULTS:</strong> There were 140 participants in the pilot study. <em>P &lt;</em>.05 was set as significant and all four modules had a <em>P </em>&lt;.000. The males were <em>not </em>significant with modules: Let’s Talk Patient &amp; Provider Communication <em>P </em>&lt;.132 and It Takes a Village<em> P</em> &lt;.066. Preterm birth status yes all of the findings were statistically significant <em>P</em>&lt;.000. Preterm birth status no Let’s Talk Patients &amp; Provider Communication was not significant <em>P </em>&lt;.106.</p> <p><strong>CONCLUSION:</strong> Overall, researchers found that with a strong research methodology and strong content relevant to the community, the participants demonstrated an increase in their knowledge in health literacy and preterm birth.</p>

Case management of preterm deliveries: Birth-registry based study

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D Baghaturia ◽  
M Kereselidze ◽  
N Skhvitaridze ◽  
T Lobjanidze
Keyword(s):  
Length Of Stay ◽  
Mode Of Delivery ◽  
Health Sector ◽  
Preterm Births ◽  
Medical Personnel ◽  
Study Data ◽  
Quality Of Data ◽  
Birth Registry ◽  
Preterm Newborns

Abstract Modern studies are possible to determine the degree of newborn's prematurity. Evidence based data from 65 countries show the increasing trend of preterm births over the past 20 years. Numbers from the National Center for Disease Control and Public Health of Georgia indicate that of 51 183 infants born in 2018, 7 071 (14%) were delivered between 34 to 37 gestational weeks. The aim of this study was to determine the similarities and differences between preterm newborns delivered at 34-37 gestational weeks according the selected variables. This is the quantitative, retrospective study. Data source was the Georgian birth registry for the year 2018. Variables, as gestational age, mode of delivery, newborn weight, Apgar score, newborn diagnoses according the ICD-10, length of stay in maternity home, and others were used for descriptive statistics. In 2018, for preterm deliveries at 34-37 gestational weeks, 53.7% of newborns were delivered by cesarean section and 46.3% physiologically. Despite the similar characteristics, majority of cases had different length of stay at maternity homes, with variation from four to 66 days. The big concern was the quality of target variables - in 30% of cases occurred missing information. Inconsistent occurred in cross-checking of variables - newborns stay at hospital over the recommended data was not justified by provided diagnosis. The results show the big variance between the preterm newborns with the similar characteristics, delivered at 34-37 gestational weeks in Georgia, mainly for the length of stay. Study reveal necessity to provide awareness rising activities among medical personnel to provide reliable, timely and validated data. The major recommendation is to advice Georgian health sector representatives to develop a mechanism for monitoring and ensuring the measures to evaluate the quality of data, uploaded in the birth registry. Key messages Reliable, consistent and validated data are contributing to the rationalization of the healthcare associated resources and controlling costs. Ongoing monitoring of quality in Georgian birth registry should be top priority of responsible authorities.

scholarly journals Infant mortality in twin pregnancies following in-utero demise of the co-twin

2015 ◽  
Vol 4 (3) ◽  
pp. 228-234
Author(s):  
Boubakari Ibrahimou ◽  
Hamisu M. Salihu ◽  
Muktar H. Aliyu ◽  
Gary English ◽  
Getachew Dagne
Keyword(s):  
Infant Mortality ◽  
In Utero ◽  
Twin Pregnancies
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