1. The impact of chorionicity on pregnancy outcome and neurodevelopment at 2 years old among twins born preterm: the EPIPAGE-2 cohort study.
- Author
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Tosello, B, Garbi, A, Blanc, J, Lorthe, E, Foix‐L'Hélias, L, D'Ercole, C, Winer, N, Subtil, D, Goffinet, F, Kayem, G, Resseguier, N, Gire, C, Ancel, Pierre‐Yves, Arnaud, Catherine, Boileau, Pascal, Debillon, Thierry, Delorme, Pierre, Desplanches, Thomas, Diguisto, Caroline, and Gascoin, Géraldine
- Subjects
PREGNANCY outcomes ,HIGH-risk pregnancy ,FETOFETAL transfusion ,TWINS ,INTENSIVE care units ,COHORT analysis ,PREMATURE infant diseases ,AGE distribution ,CHORION ,SYMPTOMS ,PLACENTA ,LONGITUDINAL method ,MULTIPLE pregnancy - Abstract
Objective: To compare the short- and mid-term outcomes of preterm twins by chorionicity of pregnancy.Design: Prospective nationwide population-based EPIPAGE-2 cohort study.Setting: 546 maternity units in France, between March and December 2011.Population: A total of 1700 twin neonates born between 24 and 34 weeks of gestation.Methods: The association of chorionicity with outcomes was analysed using multivariate regression models.Main Outcome Measures: First, survival at 2-year corrected age with or without neurosensory impairment, and second, perinatal, short-, and mid-term outcomes (survival at discharge, survival at discharge without severe morbidity) were described and compared by chorionicity.Results: In the EPIPAGE 2 cohort, 1700 preterm births were included (850 twin pregnancies). In all, 1220 (71.8%) were from dichorionic (DC) pregnancies and 480 from monochorionic (MC) pregnancies. MC pregnancies had three times more medical terminations than DC pregnancies (1.67 versus 0.51%, P < 0.001), whereas there were three times more stillbirths in MC than in DC pregnancies (10.09 versus 3.78%, P < 0.001). Both twins were alive at birth in 86.6% of DC pregnancies compared with 80.0% among MC pregnancies (P = 0.008). No significant difference according to chorionicity was found regarding neonatal deaths and morbidities. Likewise, for children born earlier than 32 weeks, the 2-year follow-up neurodevelopmental results were not significantly different between DC and MC twins.Conclusions: This study confirms that MC pregnancies have a higher risk of adverse outcomes. However, the outcomes among preterm twins admitted to neonatal intensive care units are similar irrespective of chorionicity.Tweetable Abstract: Monochorionicity is associated with adverse perinatal outcomes, but outcomes for preterm twins are comparable irrespective of their chorionicity. [ABSTRACT FROM AUTHOR]- Published
- 2021
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