Fetal and neonatal mortality among twin gestations in a Canadian population: The effect of intrapair birthweight discordance

Shi Wu Wen, Karen Fung Kee Fung, Ling Huang, Kitaw Demissie, K. S. Joseph, Alexander C. Allen, Michael S. Kramer

Research output: Contribution to journalArticlepeer-review

32 Scopus citations

Abstract

The purpose of this study was to examine the association between intrapair birthweight discordance and fetal and neonatal mortality. This was a historical cohort study, using the Statistics Canada linked birth-infant death file. Twin births in Canada (excluding Ontario) for the period 1986-1997 were studied. Outcome measures were fetal and neonatal mortality. Among 59,034 twin births, 53% had 0 to 9% birthweight difference; 30% had 10 to 19% discordance; 11% had 20 to 29% discordance; and 6% had ≥ 30% discordance. Maternal age, parity, sex discordance, and gestational age were important factors affecting birth weight discordance. Fetal death rates were 0.95, 1.26, 3.14, and 11.10%, respectively, in infants with a birthweight discordance of O to 9, 10 to 19, 20 to 29, and ≥ 30%. Corresponding figures for neonatal death rates were 1.90, 2.32, 3.05, and 8.86%, respectively. Adjustment for important confounding variables including the actual birthweight and gestational age substantially reduced the birthweight discordance-related risk of fetal and neonatal mortality, but the results remained statistically significant and clinically important. The birthweight discordance-related risk of fetal and neonatal mortality was higher in smaller twins than in larger twins and higher in infants with gestational age ≥ 37 weeks than those ≤ 37 weeks. Birthweight discordance is an important risk factor for fetal and neonatal mortality, and the birthweight discordance-related risk of fetal and neonatal mortality is higher in smaller twins than in larger twins and higher in term twins than in preterm twins.

Original languageEnglish (US)
Pages (from-to)279-286
Number of pages8
JournalAmerican Journal of Perinatology
Volume22
Issue number5
DOIs
StatePublished - Jul 2005

All Science Journal Classification (ASJC) codes

  • Obstetrics and Gynecology
  • Pediatrics, Perinatology, and Child Health

Keywords

  • Birthweight discordance
  • Canada
  • Fetal death
  • Infant death
  • Twins

Fingerprint

Dive into the research topics of 'Fetal and neonatal mortality among twin gestations in a Canadian population: The effect of intrapair birthweight discordance'. Together they form a unique fingerprint.

Cite this