Do Twins or Singletons Have a Higher Rate of Preterm Mortality?
This study by Vasak et al. (AJOG, 2016) sought to determine if there is a higher rate of mortality during the perinatal period among preterm births in singletons versus twin pregnancies.
Cohort study from the nationwide Netherlands Perinatal Registry
1,502,120 singletons and 51,658 twin pregnancies delivered after 28 weeks’ gestation were surveyed. In twin pregnancies the overall perinatal mortality rate was increased, as expected (6.6/1000 vs 4.1/1000) when compared to singleton pregnancies. However, when only the preterm period was analyzed, the risk of perinatal mortality in singletons was higher than in twins (34.5/1000 vs 10.4/1000). The authors propose a hypothesis that this finding of superior outcomes in the preterm period among twins may reflect additional monitoring and that perhaps closer surveillance could benefit singletons as well.
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