A case-control study of 1253 twin pregnancies from a 1982-1987 perinatal data base

Article Abstract:

While twin pregnancies have been generally considered high risk for both mothers and infants, few studies have evaluated the effects on risk of modern obstetrical techniques. To this end, 1,253 twin pregnancies involving infants weighing more than 500 grams were studied. These infants were born to mothers treated through the University of Illinois Perinatal Network during a five-year period who constituted a subgroup of 101,506 women delivered during this period. Several factors important in pregnancy and neonatal outcome were evaluated for twin pregnancies (the cases) and singleton pregnancies drawn from the larger group. Results showed that women with twin pregnancies were older, had had more children prior to the twin births, gained more weight when pregnant, weighed more at delivery, and delivered earlier than women with singleton births. Complications prior to delivery, such as hypertension (high blood pressure), abruption (premature detachment of the placenta), and anemia, were increased in the mothers of twins. The average weights of twins were lower than of the singletons and the twin group had a threefold increase in birth defects. Apgar scores, indexes of infants' physical conditions at one and five minutes after birth, were worse (lower) for twins. Infant mortality during the fetal and neonatal periods was increased for twins, with a fetal death rate per 1,000 births of 16 for twin A (the first twin born) and 25.6 for twin B; the singleton rate was 5.5. The neonatal death rate was 33.3 for twin A, 33.9 for twin B, and 5.6 for singletons. Overall, the perinatal mortality for twins A and B was 48.8 and 64.1, respectively, compared with the much lower rate of 10.4 per 1,000 births for singletons. Thus, it appears that twin pregnancies remain high-risk, even with modern obstetrical care. Diagnosis of twin pregnancy should be made as early as possible and prenatal visits should be frequent. (Consumer Summary produced by Reliance Medical Information, Inc.)

Patient outcomes, Mortality, Pregnancy, Complications of, Pregnancy complications

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Twin pregnancy in adolescents

Article Abstract:

In general, the incidence of low-birth-weight (LBW) infants and of infant mortality is higher among teenage mothers than among adults, especially when the mothers are poor and nonwhite. Whether twin pregnancies among this age group also have less favorable outcomes has not been evaluated, however. To better understand this issue, the medical records from twin pregnancies delivered at one medical facility during a six-year period were reviewed. Five hundred forty-seven sets of twins were born, with 50 (9 percent) to adolescent mothers under 17, 28 (5 percent) to 18- and 19-year-olds, and 395 (72 percent) to adults between 20 and 34. No differences were found between adolescents and adults for gestational age at delivery, discordant growth (different degrees of growth for the two twins), birth weights of either twin, preterm birth, hypertension (high blood pressure), or perinatal mortality. Birth weight of the first twin born was positively related to maternal age, weight, previous deliveries, and length of gestation, for both white and black women. Adolescent pregnancy, which currently makes up 14 percent of all deliveries in the US, is considered high-risk. However, the results indicate that the outcome for adolescent mothers of twins is no poorer than that for adult mothers of twins. Other research has shown that, like older women, adolescents who receive prenatal care have a lower risk for both maternal and fetal complications of pregnancy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Teenage pregnancy

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Toluene abuse during pregnancy: obstetric complications and perinatal outcomes

Article Abstract:

Toluene is a chemical substance often found in paints and glues. The fumes from substances containing the chemical can be inhaled for recreational purposes to create a mind-altering high. Toluene can cause major damage to the kidneys and sometimes causes permanent neurologic damage. Few studies have examined the effects of toluene exposure during pregnancy. One study reported that infants born to mothers who inhaled these substance during pregnancy had stunted growth and facial malformations. This study examined the effects of exposure to toluene on 30 pregnancies in 10 women who admitted sniffing glue or paint during their pregnancies. Results showed that 21 of the 30 pregnancies involved toluene exposure. Preterm labor complications occurred in 86 percent of the pregnancies and nine of the infants were born early. Three infants died, for a perinatal death rate of 14 percent, significantly higher than normal. Birth weights were significantly lower than normal. Three infants had facial deformities. At one year of age, 61.5 percent showed retarded growth. These results show that toluene abuse during pregnancy can have significant detrimental effects. Further examination of the effects of this substance on pregnancy are needed so that recognition of and treatment for these problems can be established. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Fetus, Physiological aspects, Birth defects, Toluene, Drug abuse in pregnancy

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