Effect of maternal chronic disease on obstetric complications in twin pregnancies in a United States cohort.
Effect of maternal chronic disease on obstetric complications in twin pregnancies in a United States cohort.
Available online from MWHC library: 1997 - present, Available in print through MWHC library:1999-2007
CONCLUSION(S): Chronic disease was associated with additional risk of earlier delivery and cesarean section after spontaneous labor in a nationwide sample of US twin pregnancies. Published by Elsevier Inc. DESIGN: Multicenter, retrospective, observational study. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Gestational age at delivery, gestational hypertension, pre-eclampsia, gestational diabetes, placental abruption, placenta previa, hemorrhage, chorioamnionitis, maternal postpartum fever, premature rupture of membranes, labor onset (spontaneous vs. nonspontaneous), route of delivery, and maternal admission to intensive care unit. OBJECTIVE: To evaluate the effect of maternal chronic disease on obstetric complications among twin pregnancies. PATIENT(S): Twin pregnancies (n = 4,821) delivered >= 23 weeks of gestation and classified by maternal chronic disease (either none or any of the following: asthma, depression, hypertension, diabetes, and heart, thyroid, gastrointestinal or renal disease). RESULT(S): Women with chronic disease delivered earlier (mean gestational length, 34.1 vs. 34.6 weeks) and were less likely to have term birth (risk ratio 0.80; 95% confidence interval 0.70-0.90). Cesarean delivery after spontaneous labor (risk ratio 1.20; 95% confidence interval 1.05-1.37) was also increased with chronic disease. No statistically significant effects were observed for other complications studied. Women who used assisted reproductive technology were more likely to hemorrhage, independent of chronic disease, but other findings were generally similar to the non-assisted reproductive technology sample. SETTING: Clinical centers (19 hospitals).
English
0015-0282
*Delivery, Obstetric
*Pregnancy Complications/di [Diagnosis]
*Pregnancy Complications/ep [Epidemiology]
*Pregnancy, Twin
Adult
Cesarean Section/td [Trends]
Chronic Disease
Cohort Studies
Delivery, Obstetric/td [Trends]
Female
Humans
Pregnancy
Pregnancy, Twin/ph [Physiology]
Premature Birth/di [Diagnosis]
Premature Birth/ep [Epidemiology]
Retrospective Studies
United States/ep [Epidemiology]
Young Adult
MedStar Washington Hospital Center
Obstetrics and Gynecology, Maternal-Fetal Medicine
Journal Article
Multicenter Study
Research Support, N.I.H., Intramural
Twin Study
Available online from MWHC library: 1997 - present, Available in print through MWHC library:1999-2007
CONCLUSION(S): Chronic disease was associated with additional risk of earlier delivery and cesarean section after spontaneous labor in a nationwide sample of US twin pregnancies. Published by Elsevier Inc. DESIGN: Multicenter, retrospective, observational study. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Gestational age at delivery, gestational hypertension, pre-eclampsia, gestational diabetes, placental abruption, placenta previa, hemorrhage, chorioamnionitis, maternal postpartum fever, premature rupture of membranes, labor onset (spontaneous vs. nonspontaneous), route of delivery, and maternal admission to intensive care unit. OBJECTIVE: To evaluate the effect of maternal chronic disease on obstetric complications among twin pregnancies. PATIENT(S): Twin pregnancies (n = 4,821) delivered >= 23 weeks of gestation and classified by maternal chronic disease (either none or any of the following: asthma, depression, hypertension, diabetes, and heart, thyroid, gastrointestinal or renal disease). RESULT(S): Women with chronic disease delivered earlier (mean gestational length, 34.1 vs. 34.6 weeks) and were less likely to have term birth (risk ratio 0.80; 95% confidence interval 0.70-0.90). Cesarean delivery after spontaneous labor (risk ratio 1.20; 95% confidence interval 1.05-1.37) was also increased with chronic disease. No statistically significant effects were observed for other complications studied. Women who used assisted reproductive technology were more likely to hemorrhage, independent of chronic disease, but other findings were generally similar to the non-assisted reproductive technology sample. SETTING: Clinical centers (19 hospitals).
English
0015-0282
*Delivery, Obstetric
*Pregnancy Complications/di [Diagnosis]
*Pregnancy Complications/ep [Epidemiology]
*Pregnancy, Twin
Adult
Cesarean Section/td [Trends]
Chronic Disease
Cohort Studies
Delivery, Obstetric/td [Trends]
Female
Humans
Pregnancy
Pregnancy, Twin/ph [Physiology]
Premature Birth/di [Diagnosis]
Premature Birth/ep [Epidemiology]
Retrospective Studies
United States/ep [Epidemiology]
Young Adult
MedStar Washington Hospital Center
Obstetrics and Gynecology, Maternal-Fetal Medicine
Journal Article
Multicenter Study
Research Support, N.I.H., Intramural
Twin Study