Twin Research

March 2000, Volume 3, Issue 1, Pages 2 - 6

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Article
Risk of premature birth in multifetal pregnancy

H Minakami, S Kosuge, H Fujiwara, Y Mori & I Sato

Center for Perinatal Medicine, Jichi Medical School Hospital, Minamikawachi-machi, Tochigi, 329-04 Japan    

Correspondence to: Hisanori Minakami, MD, Center for Perinatal Medicine, Jichi Medical School Hospital, Minamikawachi-machi, Tochigi, 329-0498 Japan. Tel: +81 285 44 2111; Fax: +81 285 44 8505; E-mail: minasho@jichi.ac.jp    

Keywords
low birth weight infant;   national statistics;   premature labor;   triplets;   twins

Abstract

The risk of preterm delivery (< 37 weeks of gestation) is approximately nine times higher in women with multifetal pregnancies than in women with singleton pregnancies. However, it is possible that the risk will vary according to gestational week. To assess the risk of premature birth within 1 week by gestational age among multifetal pregnancies and compare the estimated risk with that of singleton pregnancies, we analyzed 6 036 475 infants born in singleton pregnancies and 90 887 infants born in multifetal pregnancies in Japan (greater than or equal to 22 weeks) over the 5-year period 1989-1993. An estimate of the risk of birth within 1 week at gestational week n was obtained by dividing the number of infants delivered at gestational week n by the number of infants delivered at or beyond gestational week n. The risk at 22 weeks was 0.9 per 1000 fetuses for singleton pregnancies and 5.0 per 1000 for multifetal pregnancies. The risk remained relatively stable until 27 weeks of gestation, then sharply increased toward 36 weeks of gestation in both singleton and multifetal pregnancies. The odds ratio for birth within 1 week for fetuses of multifetal pregnancies compared with fetuses of singleton pregnancies was 5.9 (95% CI, 5.4-6.5) at 22 weeks of gestation, increasing gradually with increasing gestational age until 33 weeks of gestation (13.7; 95% CI, 13.1-14.2) but declining thereafter to 8.8 (95% CI, 8.6-8.9) at 36 weeks of gestation. Results of data analysis for each year of the 5-year period did not differ substantially. Twin Research (2000) 3, 2-6.

Received 4 December 1998; Revised 5 January 1999; Accepted 26 October 1999

© Macmillan Publishers Ltd 2000