Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Feb 1;23(1):89.
doi: 10.1186/s12884-023-05409-8.

Perinatal characteristics and neonatal outcomes of singletons and twins in Chinese very preterm infants: a cohort study

Min Yang #  1 , Lingyu Fang #  2 , Yanchen Wang  3 , Xiaoying Li  4 , Yun Cao  3   5 , Jianhua Sun  6 , Joseph Ting  7 , Xiafang Chen  6 , Xiaobo Fan  1 , Jiale Dai  1 , Xiaomei Tong  2 , Dongmei Chen  8 , Jimei Wang  9 ; Chinese Neonatal Network
Collaborators, Affiliations

Perinatal characteristics and neonatal outcomes of singletons and twins in Chinese very preterm infants: a cohort study

Min Yang et al. BMC Pregnancy Childbirth. .

Abstract

Background: The prevalence of preterm birth has been rising, and there is a paucity of nationwide data on the perinatal characteristics and neonatal outcomes of twin deliveries of very preterm infants (VPIs) in China. This study compared the perinatal characteristics and outcomes of singletons and twins admitted to neonatal intensive care units (NICUs) in China.

Methods: The study population comprised all infants born before 32 weeks in the Chinese Neonatal Network (CHNN) between January 2019 and December 2019. Three-level and population-average generalized estimating equation (GEE)/alternating logistic regression (ALR) models were used to determine the association of twins with neonatal morbidities and the use of NICU resources.

Results: During the study period, there were 6634 (71.2%) singletons and 2680 (28.8%) twins, with mean birth weights of 1333.70 g and 1294.63 g, respectively. Twins were significantly more likely to be delivered by caesarean section (p < 0.01), have antenatal steroid usage (p = 0.048), have been conceived by assisted reproductive technology (ART) (p < 0.01), have a higher prevalence of maternal diabetes (p < 0.01) and be inborn (p < 0.01) than singletons. In addition, twins had a lower prevalence of small for gestational age, maternal hypertension, and primigravida mothers than singletons (all p < 0.01). After adjusting for potential confounders, twins had higher mortality rates (adjusted odds ratio [AOR] 1.28, 95% confidence interval [CI] 1.10-1.49), higher incidences of short-term composite outcomes (AOR 1.28, 95% CI 1.09-1.50), respiratory distress syndrome (RDS) (AOR 1.30, 95% CI 1.12-1.50), and bronchopulmonary dysplasia (BPD) (AOR 1.10, 95% CI 1.01-1.21), more surfactant usage (AOR 1.22, 95% CI 1.05-1.41) and prolonged hospital stays (adjusted mean ratio 1.03, 95% CI 1.00-1.06), compared to singletons.

Conclusion: Our work suggests that twins have a greater risk of mortality, a higher incidence of RDS and BPD, more surfactant usage, and longer NICU stays than singletons among VPIs in China.

Keywords: Neonatal outcome; Singletons; Twins; Very preterm birth.

PubMed Disclaimer

Conflict of interest statement

No financial or non-financial benefits have been received or will be received from any party related directly or indirectly to the subject of this article.

Figures

Fig. 1
Fig. 1
Flow diagram of the study participants
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Isaacson A, Diseko M, Mayondi G, Mabuta J, Davey S, Mmalane M, et al. Prevalence and outcomes of twin pregnancies in Botswana: a national birth outcomes surveillance study. BMJ Open. 2021;11(10):e047553. doi: 10.1136/bmjopen-2020-047553. - DOI - PMC - PubMed
    1. Paulson R, Lockwood CJ. Pregnancy outcome after assisted reproductive technology. UpToDate; 2018. p. 1–14. https://www.uptodate.com/contents/pregnancy-outcome-after-assisted-repro....
    1. ACOG Practice Bulletin No 169: Multifetal gestations: twin, triplet, and higher-order multifetal pregnancies. Obstet Gynecol. 2016;128(4):e131–e146. - PubMed
    1. Santana DS, Silveira C, Costa ML, Souza RT, Surita FG, Souza JP, et al. Perinatal outcomes in twin pregnancies complicated by maternal morbidity: evidence from the WHO Multicountry Survey on Maternal and Newborn Health. BMC Pregnancy Childbirth. 2018;18(1):449. doi: 10.1186/s12884-018-2082-9. - DOI - PMC - PubMed
    1. Yeo KT, Lee QY, Quek WS, Wang YA, Bolisetty S, Lui K, et al. Trends in morbidity and mortality of extremely preterm multiple gestation newborns. Pediatrics. 2015;136:263–271. doi: 10.1542/peds.2014-4075. - DOI - PubMed

Grants and funding