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J Matern Fetal Neonatal Med. 2017 Sep 22:1-9. doi: 10.1080/14767058.2017.1379073. [Epub ahead of print]

Morbidity and mortality of very low birth weight multiples compared with singletons.

Author information

1
a Department of Neonatology-Pediatrics , Hospital Universitari Dexeus , Barcelona , Spain.
2
b Department of Neonatology , Hospital Clinic de Barcelona , Barcelona , Spain.
3
c Health Sciences Research Institute (IUNICS) , Palma de Mallorca , Spain.
4
d Hospital de la Santa Creu i Sant Pau , Barcelona , Spain.
5
e Department of Neonatology-Pediatrics , Hospital de Terrassa , Terrassa , Spain.
6
f IDIBAPS - Hospital Clinic Barcelona , Barcelona , Spain.

Abstract

BACKGROUND:

Previous studies comparing the neonatal outcome of very low birth weight (VLBW) multiples and singletons have suggested a worse outcome for multiples at gestational ages on the limits of viability.

OBJECTIVES:

The objective of this study is to determine the neonatal mortality and morbidity of VLBW multiples compared to singletons.

METHODS:

This is a retrospective study including all infants registered in the Spanish network for infants under 1500 g (SEN1500), over a 12-year period (from 2002 to 2013). Mortality and major morbidities were compared between singletons and multiples.

RESULTS:

About 32,770 infants were included: 21,123 singletons (64.5%) and 11,647 multiples (35.5%), with a mean gestational age of 29.5 weeks (22-38), and mean birth weight of 1115 g (340-1500). When adjusted by other perinatal factors, multiple pregnancy has a significantly higher risk of mortality than singleton pregnancy (odds ratio (OR) 1.15; IC 95% 1.05-1.26, p = .002), but not a higher risk of major morbidity or composite adverse outcome. In the subgroup of infants born before 26 weeks, multiples showed a higher risk of mortality (63.9% versus 51%, OR 1.7; 95% CI 1.47-1.96) and a higher risk of composite adverse outcome (88.9% versus 81.5%, OR 1.82, 95% CI 1.28-2.24).

CONCLUSIONS:

In preterm infants born with less than 1500 g, multiple pregnancy is a prognostic factor that can slightly increase mortality. Extremely preterm infants born before 26 weeks have a greater risk of mortality and major morbidity if they come from a multiple pregnancy.

KEYWORDS:

Mortality; multiples; singletons

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