 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
|
| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Jane Lazar1, Milton Kotelchuck2, Eugene R Declercq, PhD3, Mary K Barger, CNM, MPH4, Alice Richman, MPH4, and Angela Nannini, FNP, PhD5. (1) Data Coordinating Center, Boston University School of Public HEalth, 715 Albany Street, 580, Boston, MA 02118-2526, 617-638-4058, jlazar@bu.edu, (2) Boston University, 715 Albany Street, T5W, Boston, MA 02118-2526, (3) Maternal and Child Health Department, Boston University School of Public Health, 715 Albany St., Boston, MA 02118, (4) Department of Maternal and Child Health, Boston University School of Public Health, 715 Albany St., Boston, MA 02118, (5) Bureau of Family and Community Health, Massachusetts Department of Public Health, 250 Washington St. 5th Floor, Boston, MA 02108
Purpose: To determine the survival patterns for twin gestations after a single fetal demise. Multiple births in 2001 accounted for 3.2% of all infants born in the United States, the highest rate ever recorded. When one twin gestation results in an intrauterine demise, estimates for the mortality rate of the surviving twin fall between 12 to 65%.
Methods: Twin gestations occurring in MA in 1998-2000 were selected, yielding a total of over 9,000 births and fetal deaths. Infant deaths were identified using the linked birth-infant death file, created by the MA Department of Vital Statistics. Multiple gestation groups (“wombmates”) were identified by combining Massachusetts birth and fetal death certificate data and creating a unique identifier for gestational groups.
Results: Preliminary analyses of 1998 and 1999 data show that fetal death occurred in 98 out of 6,490 twins. This rate (1.5%) falls near the low end of the range of rates reported in previous studies. For pairs where one twin was liveborn and the other a fetal death, only 64 out of 100 liveborn twins survived to one year. This is 7 times the risk of death within a year of life compared with twins that were both born alive. We will present further analyses (including 2000 birth) related to the timing of these infant deaths controlling for factors such as gestational age and maternal medical conditions and including the assisted reproductive therapy variable.
Conclusions: This population-based study of twin pair survival has great potential for advancing the study of multiple gestations, examining their impact on the lives of mothers, children and families and influencing policy around the management of twin pregnancies for clinicians. This preliminary research will clarify the expected survival patterns for twin gestations and serve as a stepping stone toward further analyses of long-term morbidities associated with multiple gestations.
Learning Objectives:
Keywords: Birth Outcomes, Perinatal Outcomes
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.