The Impact of Twin Birth on Early Neonatal Outcomes

M. Fumagalli, Paola Schiavolin, L. Bassi, M. Groppo, S. Uccella, A. De Carli, Sofia Passera, Ida Sirgiovanni, F. Dessimone, D. Consonni, B. Acaia, L.A. Ramenghi, F. Mosca

Research output: Contribution to journalArticlepeer-review


Objective This study aims to describe the impact of twin birth, chorionicity, intertwin birth weight (BW) discordance and birth order on neonatal outcomes. Study Design We performed a hospital-based retrospective study on 2,170 twins (6.4% of all live births) and 2,217 singletons inborn 2007 to 2011. Data on neonatal characteristics, morbidities, and mortality were collected and compared. Univariate and multiple (adjusted for gestational age [GA] and gender) linear random intercept regression models were used. Results Overall, 62.3% of twins were born premature. At multiple regression, twins were similar to singletons for neonatal morbidities, but they were more likely to have lower BW and to be born by cesarean delivery. Monochorionic twins had lower GA and BW compared with dichorionic ones and were more likely to develop respiratory distress syndrome (odds ratio [OR], 1.7), hypoglycemia (OR, 3.3), need for transfusion, (OR, 3.4) but not brain abnormalities. Moderate and severe BW discordance were associated with longer length of stay and increased risk for morbidities but not for death. Birth order had no effects. Conclusion Prematurity was the most common outcome in twins and accounted for the apparently increased risk in morbidities. Monochorionicity was confirmed as risk factor for lower GA and neonatal morbidities. BW discordance may play a role in developing neonatal complications and needs to be further investigated. Copyright © 2016 by Thieme Medical Publishers, Inc.
Original languageEnglish
Pages (from-to)63-70
Number of pages8
JournalAmerican Journal of Perinatology
Issue number1
Publication statusPublished - 2016


  • birth order
  • birth weight discordance
  • chorionicity
  • neonatal morbidities
  • twin
  • adult
  • Article
  • birth weight
  • blood transfusion
  • cesarean section
  • female
  • gestational age
  • human
  • hypoglycemia
  • live birth
  • major clinical study
  • mortality
  • newborn
  • newborn morbidity
  • prematurity
  • priority journal
  • respiratory distress syndrome
  • retrospective study
  • twin pregnancy
  • twins
  • chorion
  • echography
  • fetus echography
  • infant
  • infant mortality
  • Italy
  • low birth weight
  • male
  • odds ratio
  • pregnancy
  • Respiratory Distress Syndrome, Newborn
  • statistical model
  • statistics and numerical data
  • Adult
  • Birth Weight
  • Cesarean Section
  • Chorion
  • Female
  • Gestational Age
  • Humans
  • Hypoglycemia
  • Infant
  • Infant Mortality
  • Infant, Extremely Premature
  • Infant, Low Birth Weight
  • Infant, Newborn
  • Logistic Models
  • Male
  • Odds Ratio
  • Pregnancy
  • Pregnancy, Twin
  • Retrospective Studies
  • Ultrasonography, Prenatal


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