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• W4200034573 abstract "Women with multiple gestations are counseled differently than singleton pregnancies for many prenatal scenarios. Limited data is available on periviable prognosis of multiple gestations as compared to singletons. We sought to determine if neonatal complications and survival rates differ according to type of gestation in periviable births. Retrospective cohort study of all infants without major congenital anomalies who delivered at our institution from 2013-2019 between 22 0/7-25 6/7 weeks gestational age (GA). Corticosteroids for fetal lung maturity were routinely administered at 22 5/7 weeks and beyond. We estimated survival milestones in a stepwise fashion: intrauterine fetal demise (IUFD) during an antepartum admission, IUFD during labor, neonatal death before NICU discharge, and confirmed survival to 1 YOL. We analyzed rates of lung disease requiring respiratory support at discharge, intraventricular hemorrhage (IVH), retinopathy of prematurity (ROP), pulmonary hypertension, and concern for cerebral palsy (CP) at 1 year of life (YOL). There were 451 singleton and 67 multiple gestation pregnancies, a total of 592 infants. Of the multiples, 75% were dichorionic twins, 20% were monochorionic/diamniotic twins, 4% were triplets and 1% were quadruplets. We had a follow-up rate of 96% to 1 YOL. Multiple gestations were more often admitted for PTL, but admissions for hypertension were less likely compared to singletons. The average GA at delivery was 24.1 weeks for singletons and 23.5 weeks for multiples (p=< 0.001). Neonatal outcomes were adjusted for this GA difference. Survival was not different at any admission milestone. Confirmed survival at 1 YOL was 51% vs 46% for singleton vs multiple gestation respectively (aOR 1.1 [0.47-1.74]). Rates of neonatal complications in surviving infants were also similar. Of the 67 multiple gestations 15 (22%) had survival of all infants, 52 (78%) had death of at least one infant. Survival and neonatal complication rates in periviable multiple gestations appear to be no different than singletons delivered at similar gestational ages.View Large Image Figure ViewerDownload Hi-res image Download (PPT)" @default.
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• W4200034573 date "2022-01-01" @default.
• W4200034573 modified "2023-10-16" @default.
• W4200034573 title "Periviable multiple gestations: Are neonatal complications different than singletons born at the same gestational age?" @default.
• W4200034573 doi "https://doi.org/10.1016/j.ajog.2021.11.1177" @default.
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