Infant mortality in twin pregnancies following in-utero demise of the co-twin
Article
Ibrahimou, B, Salihu, HM, Aliyu, MH et al. (2015). Infant mortality in twin pregnancies following in-utero demise of the co-twin
. 4(3), 228-234. 10.1016/j.apjr.2015.06.007
Ibrahimou, B, Salihu, HM, Aliyu, MH et al. (2015). Infant mortality in twin pregnancies following in-utero demise of the co-twin
. 4(3), 228-234. 10.1016/j.apjr.2015.06.007
Objective: To assess whether conversion from twin to singleton pregnancy following the demise of a co-twin influences survival. Methods: This retrospective study compared the risk for neonatal, post-neonatal and infant death for converted co-twins versus unconverted co-twins using the US matched multiple file dataset for the period 1995-2000. We also examined the same risks for converted versus same-quantile co-twins, hazard ratios (HR) and 95% confidence intervals (CI) were computed using Cox Proportional Hazards models. Results: The risk for neonatal (HR=0.18, 95% CI: 0.09-0.34 and HR=0.69, 95% CI: 0.50-0.96) and infant death (HR=0.22, 95% CI: 0.12-0.42 and HR=0.57, 95% CI: 0.42-0.77) were significantly lower for converted twins than for unconverted twins and same-quantile twins, respectively. For black compared to white, the risk for post-neonatal death increased by 89% (HR=1.89, 95% CI=1.03, 3.48), and 79% (HR=1.79, 95% CI=1.53, 2.09) for converted vs. unconverted and converted vs. same-quantile, respectively. For converted black, the risk for neonatal death decreased by 17% (HR=0.83, 95% CI=0.73-0.93) as compared to unconverted. Conclusions: Risks for all mortality types were lower among converted co-twins than their unconverted or same-quantile counterparts. The lower neonatal and higher post-neonatal mortality among black require future research.
