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Minerva Pediatrica 2019 Nov 05

DOI: 10.23736/S0026-4946.19.05592-0


language: English

Neonatal outcomes of multiple versus single very preterm infants

Gustavo ROCHA 1 , Filipa FLOR-DE-LIMA 1, 2, Ana P. MACHADO 3, Hercília GUIMARAES 1, 2, Hypertensive Disorders of Pregnancy Study Group 

1 Department of Neonatology, Centro Hospitalar Universitário São João, Porto, Portugal; 2 Faculty of Medicine, University of Porto, Porto, Portugal; 3 Department of Obstetrics and Gynaecology, Centro Hospitalar Universitário São João, Porto Portugal


BACKGROUND: Neonatal morbidity and mortality differ between very preterm infants that result from single and those that result from a multiple order pregnancy. The aim of our study was to assess and compare the neonatal morbidity and mortality of multiple versus single very preterm infants.
METHODS: Obstetrical and neonatal data on mothers and preterm infants with gestational ages between 24 and 30 weeks, born during 2015 and 2016 at 11 level III perinatal centers after a surveilled pregnancy, were analyzed and compared. Statistical analysis was performed using IBM SPSS® statistics 25 and a p-value < 0.05 was considered statistically significant.
RESULTS: A total of 494 infants delivered from 410 women were enrolled in the study; 320 (64.8%) infants resulted from single gestation and 174 (35.2%) resulted from multiple order gestation (double=153, triple=21). Multiples were associated with a higher maternal age, a greater use of medically assisted reproduction techniques, higher C- section rates, more frequent full cycle use of antenatal corticosteroids, higher gestational age with adequate birth weight, spent less days on oxygen therapy, presented less prevalence of BPD and cPVL, needed less surgical closure of PDA and had a lower length of stay in NICU. Abruptio placenta, hypertensive disorders of pregnancy and preeclampsia were more frequent in single pregnancies. The multivariate analysis by logistic regression adjusted to gestational age and confounding variables did not show any significant difference on the outcomes of multiples compared to singles.
CONCLUSIONS: The results of our study support the scientific evidence that, with the current practices, the neonatal morbidity and mortality of very premature infants are not different between those resulting from single and multiple gestations.

KEY WORDS: Multiple order gestation; Single gestation; Very preterm infant; Neonatal morbidity

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