Perinatal conditions of late preterm twins versus early term twins

ZHANG Yi-Min, SHAO Shu-Ming, ZHANG Xiao-Rui, LIU Jie, ZENG Chao-Mei

Chinese Journal of Contemporary Pediatrics ›› 2021, Vol. 23 ›› Issue (3) : 242-247.

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Chinese Journal of Contemporary Pediatrics ›› 2021, Vol. 23 ›› Issue (3) : 242-247. DOI: 10.7499/j.issn.1008-8830.2011126
CLINICAL RESEARCH

Perinatal conditions of late preterm twins versus early term twins

  • ZHANG Yi-Min, SHAO Shu-Ming, ZHANG Xiao-Rui, LIU Jie, ZENG Chao-Mei
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Abstract

Objective To study the perinatal complications of late preterm twins (LPTs) versus early term twins (ETTs). Methods A retrospective analysis was performed for the complications of 246 LPTs, 496 ETTs, and their mothers. The risk factors for late preterm birth were analyzed. According to gestational age, the twins were divided into five groups: 34-34+6 weeks (n=44), 35-35+6 weeks (n=70), 36-36+6 weeks (n=132), 37-37+6 weeks (n=390), and 38-38+6 weeks (n=106). The perinatal complications were compared between groups. Results Maternal hypertension, maternal thrombocytopenia, placenta previa, and premature rupture of membranes were independent risk factors for late preterm birth in twins (P < 0.05). The LPT group had higher incidence rates of respiratory diseases, feeding intolerance, and hypoglycemia than the ETT group (P < 0.05). The 34-34+6 weeks group had a higher incidence rate of neonatal asphyxia than the 37-37+6 weeks and 38-38+6 weeks groups; and had a higher incidence rate of septicemia than 36-36+6 weeks group (P < 0.0045). The 34-34+6 weeks and 35-35+6 weeks groups had higher incidence rates of neonatal respiratory distress syndrome, neonatal apnea, and anemia than the other three groups; and had higher incidence rates of neonatal pneumonia, hypoglycemia and septicemia than the 37-37+6 weeks and 38-38+6 weeks groups (P < 0.0045). The 35-35+6 weeks group had a higher incidence rate of feeding intolerance than the 36-36+6 weeks, 37-37+6 weeks, and 38-38+6 weeks groups (P < 0.0045). The 36-36+6 weeks group had a lower incidence rate of hypoglycemia than the 34-34+6 weeks group and a higher incidence rate of hypoglycemia than the 37-37+6 weeks group (P < 0.0045). Conclusions Compared with ETTs, LPTs have an increased incidence of perinatal complications. The incidence of perinatal complications is associated with gestational ages in the LPTs and ETTs.

Key words

Twins / Perinatal period / Complication / Late preterm infant / Early term infant

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ZHANG Yi-Min, SHAO Shu-Ming, ZHANG Xiao-Rui, LIU Jie, ZENG Chao-Mei. Perinatal conditions of late preterm twins versus early term twins[J]. Chinese Journal of Contemporary Pediatrics. 2021, 23(3): 242-247 https://doi.org/10.7499/j.issn.1008-8830.2011126

References

[1] 戴钟英. 多胎妊娠的原因及流行病学调查[J]. 中国实用妇科与产科杂志, 2002, 18(2):65-66.
[2] 魏军, 刘彩霞, 崔红, 等. 双胎早产诊治及保健指南(2020年版)[J]. 中国实用妇科与产科杂志, 2020, 36(10):949-956.
[3] Vogel JP, Torloni MR, Seuc A, et al. Maternal and perinatal outcomes of twin pregnancy in 23 low- and middle-income countries[J]. PLoS One, 2013, 8(8):e70549.
[4] Raju TN, Higgins RD, Stark AR, et al. Optimizing care and outcome for late-preterm (near-term) infants:a summary of the workshop sponsored by the National Institute of Child Health and Human Development[J]. Pediatrics, 2006, 118(3):1207-1214.
[5] 韩彤妍, 童笑梅, 张欣, 等. 北京地区晚期早产儿出生早期呼吸系统疾病的多中心现状调查[J]. 中华实用儿科临床杂志, 2020, 35(16):1230-1234.
[6] Woythaler M. Neurodevelopmental outcomes of the late preterm infant[J]. Semin Fetal Neonatal Med, 2019, 24(1):54-59.
[7] Spong CY. Defining "term" pregnancy:recommendations from the Defining "Term" Pregnancy Workgroup[J]. JAMA, 2013, 309(23):2445-2446.
[8] Tita ATN, Jablonski KA, Bailit JL, et al. Neonatal outcomes of elective early-term births after demonstrated fetal lung maturity[J]. Am J Obstet Gynecol, 2018, 219(3):296.e1-296.e8.
[9] Ananth CV, Goldenberg RL, Friedman AM, et al. Association of temporal changes in gestational age with perinatal mortality in the United States, 2007-2015[J]. JAMA Pediatr, 2018, 172(7):627-634.
[10] Stewart DL, Barfield WD, Committee on Fetus and Newborn. Updates on an at-risk population:late-preterm and early-term infants[J]. Pediatrics, 2019, 144(5):e20192760.
[11] 梁晶晶, 胡艳, 邢艳菲, 等. 晚期早产儿和早期足月儿1岁时神经心理发育水平的随访研究[J]. 中国当代儿科杂志, 2020, 22(7):706-710.
[12] Tamai K, Yorifuji T, Takeuchi A, et al. Associations of gestational age with child health and neurodevelopment among twins:a nationwide Japanese population-based study[J]. Early Hum Dev, 2019, 128:41-47.
[13] 张晓蕊, 曾超美, 刘捷. 晚期早产及早期足月双胎新生儿围产期并发症的临床研究[J]. 中华临床医师杂志(电子版), 2016, 10(4):511-516.
[14] 邵肖梅, 叶鸿瑁, 丘小汕. 实用新生儿学[M]. 4版. 北京:人民卫生出版社, 2011.
[15] Murray SR, Shenkin SD, Mcintosh K, et al. Long term cognitive outcomes of early term (37-38 weeks) and late preterm (34-36 weeks) births:a systematic review[J]. Wellcome Open Res, 2017, 2:101.
[16] Santana DS, Silveira C, Costa ML, et al. Perinatal outcomes in twin pregnancies complicated by maternal morbidity:evidence from the WHO Multicountry Survey on Maternal and Newborn Health[J]. BMC Pregnancy Childbirth, 2018, 18(1):449.
[17] Bernardes TP, Zwertbroek EF, Broekhuijsen K, et al. Delivery or expectant management for prevention of adverse maternal and neonatal outcomes in hypertensive disorders of pregnancy:an individual participant data meta-analysis[J]. Ultrasound Obstet Gynecol, 2019, 53(4):443-453.
[18] Wyszynski DF, Carman WJ, Cantor AB, et al. Pregnancy and birth outcomes among women with idiopathic thrombocytopenic purpura[J]. J Pregnancy, 2016, 2016:8297407.
[19] Ismail KI, Hannigan A, O'donoghue K, et al. Abnormal placental cord insertion and adverse pregnancy outcomes:a systematic review and meta-analysis[J]. Syst Rev, 2017, 6(1):242.
[20] American College of Obstetricians and Gynecologists' Committee on Practice Bulletins-Obstetrics. Prelabor rupture of membranes:ACOG practice bulletin, number 217[J]. Obstet Gynecol, 2020, 135(3):e80-e97.
[21] Martinka D, Barrett J, Mei-Dan E, et al. Respiratory morbidity in late preterm twin infants[J]. Arch Gynecol Obstet, 2019, 300(2):337-345.
[22] Kosinska-Kaczynska K, Szymusik I, Bomba-Opon D, et al. Late prematurity in twins:a Polish multicenter study[J]. Twin Res Hum Genet, 2014, 17(5):369-375.
[23] Liu L, Oza S, Hogan D, et al. Global, regional, and national causes of under-5 mortality in 2000-15:an updated systematic analysis with implications for the Sustainable Development Goals[J]. Lancet, 2016, 388(10063):3027-3035.
[24] Kalyoncu O, Aygün C, Cetino?lu E, et al. Neonatal morbidity and mortality of late-preterm babies[J]. J Matern Fetal Neonatal Med, 2010, 23(7):607-612.
[25] Gu MH, Amanda F, Yuan TM. Brain injury in neonatal hypoglycemia:a hospital-based cohort study[J]. Clin Med Insights Pediatr, 2019, 13:1179556519867953.
[26] Kirpalani H, Whyte RK. What is new about transfusions for preterm infants? An update[J]. Neonatology, 2019, 115(4):406-410.
[27] Berezowsky A, Mazkereth R, Ashwal E, et al. Neonatal outcome of late preterm uncomplicated monochorionic twins:what is the optimal time for delivery?[J]. J Matern Fetal Neonatal Med, 2016, 29(8):1252-1256.
[28] 肖万祥, 杨婷, 张炼. 新生儿高胆红素血症再入院的现状和危险因素分析[J]. 中国当代儿科杂志, 2020, 22(9):948-952.
[29] Ewing AC, Ellington SR, Shapiro-Mendoza CK, et al. Full-term small-for-gestational-age newborns in the U.S.:characteristics, trends, and morbidity[J]. Matern Child Health J, 2017, 21(4):786-796.

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