Perinatal outcome of dichorionic and monochorionic‐diamniotic Finnish twins: a historical cohort study
Abstract Introduction Although the perinatal mortality of monochorionic twins has been reported to be higher, the role of chorionicity is debated and data from Finland are still lacking. To examine the effect of chorionicity on the main outcome measures, perinatal and neonatal mortality and neonatal...
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Wiley
2022-01-01
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| Series: | Acta Obstetricia et Gynecologica Scandinavica |
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| Online Access: | https://doi.org/10.1111/aogs.14285 |
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| author | Annu‐Riikka S. Rissanen Mika Gissler Irmeli K. Nupponen Mika E. Nuutila Riina M. Jernman |
| author_facet | Annu‐Riikka S. Rissanen Mika Gissler Irmeli K. Nupponen Mika E. Nuutila Riina M. Jernman |
| author_sort | Annu‐Riikka S. Rissanen |
| collection | DOAJ |
| description | Abstract Introduction Although the perinatal mortality of monochorionic twins has been reported to be higher, the role of chorionicity is debated and data from Finland are still lacking. To examine the effect of chorionicity on the main outcome measures, perinatal and neonatal mortality and neonatal morbidity of Finnish twins, a comprehensive population‐based historical cohort study was performed at Helsinki University Hospitals. Material and methods All 1034 dichorionic and monochorionic‐diamniotic twin pregnancies managed at Helsinki University Hospital area during 2006, 2010, 2014 and 2018 were collected from patient databases. Information on chorionicity was retrieved from ultrasound reports and all relevant clinical information from patient records. Differences in perinatal and neonatal mortality and neonatal morbidity were analyzed by performing group comparisons between the twins and chorionicity. The role of chorionicity was also assessed in logistic regression analyses. Results There were 1034 dichorionic‐diamniotic (DCDA, n = 789, 76.3%, 95% confidence interval [CI] 73.6–78.9) and monochorionic‐diamniotic (MCDA, n = 245, 23.7%, 95% CI 21.4–26.0) twin pregnancies during the studied years. Most (n = 580, 56.1%, 95% CI 52.8–59.2) twins were born at term, but 151 (61.6%, 95% CI 55.8–67.3) of MCDA twins were preterm and had lower birthweight and Apgar scores and higher risk of death of one twin. Perinatal and neonatal mortality did not differ between twins A and B, but the immediate outcome of twin B was worse, with lower arterial pH and Apgar scores and increased need of neonatal intensive care unit treatment. Conclusions Chorionicity contributes to the perinatal and neonatal outcome in favor of dichorionic twins. This disadvantage of MCDA twinning is likely explained by earlier gestational age at birth and inequal placental sharing. Irrespective of chorionicity, twin B faces more complications. |
| format | Article |
| id | doaj-art-86b568a36e5d41d481d0ed0b12da371e |
| institution | OA Journals |
| issn | 0001-6349 1600-0412 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
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| series | Acta Obstetricia et Gynecologica Scandinavica |
| spelling | doaj-art-86b568a36e5d41d481d0ed0b12da371e2025-08-20T02:36:42ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122022-01-01101115316210.1111/aogs.14285Perinatal outcome of dichorionic and monochorionic‐diamniotic Finnish twins: a historical cohort studyAnnu‐Riikka S. Rissanen0Mika Gissler1Irmeli K. Nupponen2Mika E. Nuutila3Riina M. Jernman4Obstetrics and Gynecology University of Helsinki Helsinki FinlandFinnish Institute for Health and Welfare Helsinki FinlandChildren’s Hospital University of Helsinki and Helsinki University Hospital Helsinki FinlandObstetrics and Gynecology University of Helsinki and Helsinki University Hospital Helsinki FinlandObstetrics and Gynecology University of Helsinki and Helsinki University Hospital Helsinki FinlandAbstract Introduction Although the perinatal mortality of monochorionic twins has been reported to be higher, the role of chorionicity is debated and data from Finland are still lacking. To examine the effect of chorionicity on the main outcome measures, perinatal and neonatal mortality and neonatal morbidity of Finnish twins, a comprehensive population‐based historical cohort study was performed at Helsinki University Hospitals. Material and methods All 1034 dichorionic and monochorionic‐diamniotic twin pregnancies managed at Helsinki University Hospital area during 2006, 2010, 2014 and 2018 were collected from patient databases. Information on chorionicity was retrieved from ultrasound reports and all relevant clinical information from patient records. Differences in perinatal and neonatal mortality and neonatal morbidity were analyzed by performing group comparisons between the twins and chorionicity. The role of chorionicity was also assessed in logistic regression analyses. Results There were 1034 dichorionic‐diamniotic (DCDA, n = 789, 76.3%, 95% confidence interval [CI] 73.6–78.9) and monochorionic‐diamniotic (MCDA, n = 245, 23.7%, 95% CI 21.4–26.0) twin pregnancies during the studied years. Most (n = 580, 56.1%, 95% CI 52.8–59.2) twins were born at term, but 151 (61.6%, 95% CI 55.8–67.3) of MCDA twins were preterm and had lower birthweight and Apgar scores and higher risk of death of one twin. Perinatal and neonatal mortality did not differ between twins A and B, but the immediate outcome of twin B was worse, with lower arterial pH and Apgar scores and increased need of neonatal intensive care unit treatment. Conclusions Chorionicity contributes to the perinatal and neonatal outcome in favor of dichorionic twins. This disadvantage of MCDA twinning is likely explained by earlier gestational age at birth and inequal placental sharing. Irrespective of chorionicity, twin B faces more complications.https://doi.org/10.1111/aogs.14285chorionicityneonatalperinatal mortalitypregnancytwins |
| spellingShingle | Annu‐Riikka S. Rissanen Mika Gissler Irmeli K. Nupponen Mika E. Nuutila Riina M. Jernman Perinatal outcome of dichorionic and monochorionic‐diamniotic Finnish twins: a historical cohort study Acta Obstetricia et Gynecologica Scandinavica chorionicity neonatal perinatal mortality pregnancy twins |
| title | Perinatal outcome of dichorionic and monochorionic‐diamniotic Finnish twins: a historical cohort study |
| title_full | Perinatal outcome of dichorionic and monochorionic‐diamniotic Finnish twins: a historical cohort study |
| title_fullStr | Perinatal outcome of dichorionic and monochorionic‐diamniotic Finnish twins: a historical cohort study |
| title_full_unstemmed | Perinatal outcome of dichorionic and monochorionic‐diamniotic Finnish twins: a historical cohort study |
| title_short | Perinatal outcome of dichorionic and monochorionic‐diamniotic Finnish twins: a historical cohort study |
| title_sort | perinatal outcome of dichorionic and monochorionic diamniotic finnish twins a historical cohort study |
| topic | chorionicity neonatal perinatal mortality pregnancy twins |
| url | https://doi.org/10.1111/aogs.14285 |
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