Korean J Perinatol.  2011 Mar;22(1):22-29.

Differences in Mortality and Morbidity according to Birth Order in Preterm Twins Born by Cesarean Section

• Choi KY
• Lee JH
• Sung TJ

Abstract

PURPOSE
Birth rate of preterm twins has gradually increased recently, and preterm twins have higher morbidity and higher mortality compared with term twins. Hence, we carried out the study to find out whether there were differences in mortality and morbidity according to birth order.
METHODS
We examined the medical records of premature babies, who were born under 37 weeks of gestational age from January, 2004 to December, 2009. Among 226 twins (113 pairs),we compared the following parameters between the first-born twins and the second-born twins: birth weight, Apgar score at 1 & 5 minutes, days of ventilator use, days of total oxygenation use, hemoglobin after birth, maximum total bilirubin within 4 weeks, mortality, and morbidities including transient tachypnea of newborn (TTN), respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD), patent ductus arteriosus (PDA), retinopathy of prematurity (ROP), brain white matter disease (WMD), necrotizing enterocolitis (NEC), and sepsis.
RESULTS
There were no difference between birth weight, Apgar score at 1 & 5 minute, duration of ventilator use, duration of total oxygenation use, hemoglobin after the birth, maximum total bilirubin and morbidities. Moreover, there were no statistical differences in mortality between the first twin and the second (3.5% vs. 4.4%, P=0.734). Subdivided into preterm twins less than 32 weeks of gestational age, mortalities were 13.3% vs. 16.7% (P=0.718). There were no differences in morbidity and other factors between two groups.
CONCLUSION
According to our study, there were no notable statistical differences in mortality and morbidity based on birth order of preterm twins. However, larger studies are necessary.

Keyword

Twin; Prematurity; Neonatal mortality; Neonatal morbidity

MeSH Terms

Apgar Score
Bilirubin
Birth Order
Birth Rate
Birth Weight
Brain
Bronchopulmonary Dysplasia
Cesarean Section
Ductus Arteriosus, Patent
Enterocolitis, Necrotizing
Female
Gestational Age
Hemoglobins
Humans
Infant
Infant Mortality
Infant, Newborn
Leukoencephalopathies
Medical Records
Oxygen
Parturition
Pregnancy
Retinopathy of Prematurity
Transient Tachypnea of the Newborn
Twins
Ventilators, Mechanical
Bilirubin
Hemoglobins
Oxygen