Format

Send to:

Choose Destination
See comment in PubMed Commons below
Obstet Gynecol. 2008 Feb;111(2 Pt 1):301-8. doi: 10.1097/AOG.0b013e318160d65d.

Twin chorionicity and the risk of stillbirth.

Author information

  • 1Division of Maternal Fetal Medicine, Department of Obstetrics & Gynecology, Columbia University Medical Center, New York, New York 10032, USA. yml9002@med.cornell.edu

Erratum in

  • Obstet Gynecol. 2008 May;111(5):1217.

Abstract

OBJECTIVE:

To estimate the effect of chorionicity on the risk of stillbirth in twins.

METHODS:

A retrospective cohort analysis was performed of all twin deliveries of at least 24 weeks of gestation at a single tertiary care center from December 2000 to May 2007. The risk of fetal death with advancing gestation was calculated for monochorionic-diamniotic twins and for dichorionic-diamniotic twins. Overall in utero survival was compared by using Kaplan-Meier analysis and a hazards ratio with 95% confidence intervals estimated to assess the degree of difference. Pregnancies affected by growth abnormalities, anomalies, or twin-twin transfusion syndrome were subsequently excluded and survival by chorionicity similarly compared within these "apparently normal" gestations.

RESULTS:

Data from 1,000 consecutive twin pairs (196 monochorionic-diamniotic twins and 804 dichorionic-diamniotic twins) were analyzed. Stillbirths occurred in seven (3.6%) monochorionic-diamniotic and nine (1.1%) dichorionic-diamniotic twin pairs. Monochorionic-diamniotic twins had a higher risk of stillbirth compared with dichorionic-diamniotic twins, both overall (log-rank P=.004) and at each gestational age after 24 weeks, with this risk persisting in the subset of 771 (130 monochorionic-diamniotic twins and 641 dichorionic-diamniotic twins) "apparently normal" twins (log-rank P=.039).

CONCLUSION:

Monochorionicity has a negative effect on the in utero survival of twins, even among monochorionic-diamniotic twins without abnormalities.

LEVEL OF EVIDENCE:

II.

PMID:
18238966
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Loading ...
    Write to the Help Desk