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1. Longitudinal Growth and Body Composition of Twins versus Singletons in the First Month of Life

Author

Giulia Paviotti, Angela De Cunto, Laura Travan, Jenny Bua, Gabriele Cont, and Sergio Demarini

Subjects
Technology, Medicine, Science
Abstract

Background. Although twin gestation is well recognized to be associated with impaired fetal and postnatal growth, specific data about body composition of twins in the first month of life are scarce. Objective. The aim of this study was to compare the body composition of twins, evaluated with air-displacement plethysmography, to that of singletons of similar gestational age and adequacy of growth, during the first month of life. We tested the hypothesis that the quality of growth would be similar. Methods. Anthropometric and air-displacement plethysmography measurements were performed in 18 pairs of twins and in 36 singleton neonates, longitudinally, from birth to the 30th day of life. Each twin was matched to a singleton infant of similar gestational age and birth weight z-score. Results. With regard to anthropometric measures, the only difference was a lower weight in twins versus singletons on the 15th day of life. With regard to body composition, we did not find any difference between groups at any time point. Fat mass increased significantly from day 1 to day 30 in both twins and singletons. Conclusion. In terms of body composition, twins do not differ from singletons of similar gestational age and weight, either at birth or in early postnatal life.

Published
2013
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2. Interinstitutional Variation of Caesarean Delivery Rates According to Indications in Selected Obstetric Populations: A Prospective Multicenter Study

Author

Gianpaolo Maso, 1, 2 Monica Piccoli, 2 Marcella Montico, 3 LorenzoMonasta, 3 Luca Ronfani, 3 Sara Parolin, 2 Carmine Gigli, 4 Daniele Domini, 4 Claudio Fiscella, 5 Sara Casarsa, 5 Carlo Zompicchiatti, 6 Michela De Agostini, 6 Attilio D’Atri, 7 RaffaelaMugittu, 7 Santo La Valle, 8 Cristina Di Leonardo, 8 Valter Adamo, 9 Mara Fracas, 9 Giovanni Del Frate, 10 Monica Olivuzzi, 10 Silvio Giove, 11 Maria Parente, 11 Daniele Bassini, 12 Simona Melazzini, 2 Caterina Businelli, 2 Franco G. Toffoletti, 2 DiegoMarchesoni, 13 Alberto Rossi, 13 Sergio Demarini, 14 Laura Travan, 14 Giorgio Simon, 15 Sandro Zicari, 16 Giorgio Tamburlini, 1, 17, Salvatore Alberico1, GUASCHINO, SECONDO, Gianpaolo, Maso, 2 Monica, Piccoli, 2 Marcella, Montico, 3, Lorenzomonasta, 3 Luca, Ronfani, 3 Sara, Parolin, 2 Carmine, Gigli, 4 Daniele, Domini, 4 Claudio, Fiscella, 5 Sara, Casarsa, 5 Carlo, Zompicchiatti, 6 Michela De, Agostini, 6 Attilio, D’Atri, 7, Raffaelamugittu, 7 Santo La, Valle, 8 Cristina Di, Leonardo, 8 Valter, Adamo, 9 Mara, Fraca, 9 Giovanni Del, Frate, 10 Monica, Olivuzzi, 10 Silvio, Giove, 11 Maria, Parente, 11 Daniele, Bassini, 12 Simona, Melazzini, Guaschino, Secondo, 2 Caterina, Businelli, 2 Franco G., Toffoletti, 2, Diegomarchesoni, 13 Alberto, Rossi, 13 Sergio, Demarini, 14 Laura, Travan, 14 Giorgio, Simon, 15 Sandro, Zicari, 16 Giorgio, Tamburlini, 1, 17, and Salvatore, Alberico1

Subjects
Adult, medicine.medical_specialty, Article Subject, Caesarean delivery, lcsh:Medicine, General Biochemistry, Genetics and Molecular Biology, Pregnancy, Spontaneous labour, medicine, Humans, Prospective Studies, Prospective cohort study, Gynecology, cesarean section, General Immunology and Microbiology, business.industry, lcsh:R, Academies and Institutes, General Medicine, medicine.disease, Italy, Multicenter study, Female, Failure to progress, business, Research Article
Abstract

The aim of the study was to identify which groups of women contribute to interinstitutional variation of caesarean delivery (CD) rates and which are the reasons for this variation. In this regard, 15,726 deliveries from 11 regional centers were evaluated using the 10-group classification system. Standardized indications for CD in each group were used. Spearman’s correlation coefficient was used to calculate (1) relationship between institutional CD rates and relative sizes/CD rates in each of the ten groups/centers; (2) correlation between institutional CD rates and indications for CD in each of the ten groups/centers. Overall CD rates correlated with both CD rates in spontaneous and induced labouring nulliparous women with a single cephalic pregnancy at term (P=0.005). Variation of CD rates was also dependent on relative size and CD rates in multiparous women with previous CD, single cephalic pregnancy at term (P<0.001). As for the indications, “cardiotocographic anomalies” and “failure to progress” in the group of nulliparous women in spontaneous labour and “one previous CD” in multiparous women previous CD correlated significantly with institutional CD rates (P=0.021,P=0.005, andP<0.001, resp.). These results supported the conclusion that only selected indications in specific obstetric groups accounted for interinstitutional variation of CD rates.

Published
2013
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