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,Lee Shoo K.,Chen Chao,Du Lizhong,Zhou Wenhao,Xu Falin,Tian Xiuying,Zhang Huayan,Ji Yong,Li Zhankui,Shi Jingyun,Xue Xindong,Yang Chuanzhong,Wang Sannan,Liu Ling,Gao Xirong,Wu Hui,Yang Changyi,Han Shuping,Shan Ruobing,Jiang Hong,Qiu Gang,Wei Qiufen,Cheng Rui,Kang Wenqing,Li Mingxia,Dai Yiheng,Wang Lili,Liu Jiangqin,Lin Zhenlang,Shi Yuan,Cheng Xiuyong,Pan Jiahua,Zhang Qin,Feng Xing,Zhou Qin,Li Long,Chen Pingyang,Yang Ling,Zhuang Deyi,Zhang Yongjun,Feng Jinxing,Li Li,Lin Xinzhu,Qiu Yinping,Liang Kun,Ma Li,Chen Liping,Zhang Liyan,Song Hongxia,Yin Zhaoqing,Hei Mingyan,Huang Huiwen,Yang Jie,Li Dong,Ding Guofang,Zhang Qianshen,Ma Xiaolu,
Abstract
AbstractBackgroundThe 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.MethodsThe 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.ResultsDuring 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 (allp < 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.ConclusionOur 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.
Publisher
Springer Science and Business Media LLC
Subject
Obstetrics and Gynecology