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Perinatal characteristics and neonatal outcomes of singletons and twins in Chinese very preterm infants: a cohort study
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 t...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9890855/ https://www.ncbi.nlm.nih.gov/pubmed/36726075 http://dx.doi.org/10.1186/s12884-023-05409-8 |
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author | Yang, Min Fang, Lingyu Wang, Yanchen Li, Xiaoying Cao, Yun Sun, Jianhua Ting, Joseph Chen, Xiafang Fan, Xiaobo Dai, Jiale Tong, Xiaomei Chen, Dongmei Wang, Jimei |
author_facet | Yang, Min Fang, Lingyu Wang, Yanchen Li, Xiaoying Cao, Yun Sun, Jianhua Ting, Joseph Chen, Xiafang Fan, Xiaobo Dai, Jiale Tong, Xiaomei Chen, Dongmei Wang, Jimei |
author_sort | Yang, Min |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-9890855 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-98908552023-02-02 Perinatal characteristics and neonatal outcomes of singletons and twins in Chinese very preterm infants: a cohort study Yang, Min Fang, Lingyu Wang, Yanchen Li, Xiaoying Cao, Yun Sun, Jianhua Ting, Joseph Chen, Xiafang Fan, Xiaobo Dai, Jiale Tong, Xiaomei Chen, Dongmei Wang, Jimei BMC Pregnancy Childbirth Research 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. BioMed Central 2023-02-01 /pmc/articles/PMC9890855/ /pubmed/36726075 http://dx.doi.org/10.1186/s12884-023-05409-8 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Yang, Min Fang, Lingyu Wang, Yanchen Li, Xiaoying Cao, Yun Sun, Jianhua Ting, Joseph Chen, Xiafang Fan, Xiaobo Dai, Jiale Tong, Xiaomei Chen, Dongmei Wang, Jimei Perinatal characteristics and neonatal outcomes of singletons and twins in Chinese very preterm infants: a cohort study |
title | Perinatal characteristics and neonatal outcomes of singletons and twins in Chinese very preterm infants: a cohort study |
title_full | Perinatal characteristics and neonatal outcomes of singletons and twins in Chinese very preterm infants: a cohort study |
title_fullStr | Perinatal characteristics and neonatal outcomes of singletons and twins in Chinese very preterm infants: a cohort study |
title_full_unstemmed | Perinatal characteristics and neonatal outcomes of singletons and twins in Chinese very preterm infants: a cohort study |
title_short | Perinatal characteristics and neonatal outcomes of singletons and twins in Chinese very preterm infants: a cohort study |
title_sort | perinatal characteristics and neonatal outcomes of singletons and twins in chinese very preterm infants: a cohort study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9890855/ https://www.ncbi.nlm.nih.gov/pubmed/36726075 http://dx.doi.org/10.1186/s12884-023-05409-8 |
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