Abstract
Objective: The aim of this study is to present pregnancy and perinatal outcomes of twin gestations in older women and compare them with that for younger women. Study design: We conducted a retrospective cohort study of twin pregnancies in our department between 1988 and 2003. The women were classified into two groups by maternal age: women of age 35 years and older (study group) and women less than 35 years (control group). Population characteristics, complications during pregnancy and delivery, and neonatal outcomes were assessed. The Student’s t-test, χ2 test, Fisher exact test, and binary logistic regression analysis were used to examine the relationship between maternal age and the different variables. Results: A total of 238 twin pregnancies were enrolled (study group, 57 women; control group, 181 women). Spontaneous conceptions were significantly higher in the control group (P<0.001), while conceptions after in vitro fertilization (IVF) were significantly higher in study group (P<0.001). Mean figures of gestational age at delivery and birth weight for the older group did not differ significantly from the younger group. Although the antepartum and intrapartum complications were more common in the study group, they were not statistically significant compared to the control group. This was also true for the perinatal outcomes. Only the very low birth weight (VLBW<1,500 g) rate was significantly higher in the study group. The number of perinatal deaths was similar on comparison by maternal age. Conclusions: Based on our study, advanced maternal age at twin gestation does not seem to affect significantly pregnancy complications and perinatal outcomes. VLBW was the only unfavorable perinatal outcome related to advanced maternal age.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Bianco A, Stone J, Lynch L, Lapinski R, Berkowitz G, Berkowitz R (1996) Pregnancy outcome at age 40 and older. Obstet Gynecol 87:917–922
Bernasko J, Lunch L, Lapinski R, Berkowitz R (1997) Twin pregnancies conceived by assisted reproductive techniques: maternal and neonatal outcomes. Obstet Gynecol 89:368–372
Bureau of Census: Fertility of American women (1989) Current population reports. Government printing office. Washington DC. SeriesP-20: No 434
Casey B, Mcintire D, Leveno K (2001) The continuing values of the Apgar score for the assessment of newborn infants. N Engl J Med 344:467–471
Chin LY, Whyte R, Avis K, Thiessen P, Matthew D, Lee SK (2001) Improved outcome of preterm infants when delivered in tertiary care centers. Obstet Gynecol 98:247–252
Corchia C, Masatroiacovo P, Lanni R, et al (1996) What proportion of multiple births are due to ovulation induction? A registered-based study in Italy. Am J Public Health 86:6
Cunningham FG, Leveno KJ (1990) Maternal age and outcome of pregnancy. N Engl J Med 323:414–415
Daniel Y, Ochshorn Y, Fait G, Geva E, Bar-Am A, Lessing J (2000) Analysis of 104 twin pregnancies conceived with assisted reproductive technologies and 193 spontaneously conceived twin pregnancies. Fertil Steril 74:683–689
Edge VL, Laros RK (1993) Pregnancy outcome in nulliparous women aged 35 or older. Am J Obstet Gynecol 168:1881–1885
Imaizuni Y (1997) Trends of twining rates in ten countries, 1972-1996. Acta Genet Med Gemel 46:209–218
Jones JM, Sbarram AJ, Certulo CL (1990) Antepartum management of twin gestation. Clin Obstet Gynecol 33:32–41
Manoura A, Korakaki E, Hatzidaki E, Bikouvarakis S, Papageorgiou M, Giannakoloulou C (2004) Perinatal outcomes of twin pregnancies after in vitro fertilization. Acta Obstet Gynecol Scand 83:1079–1084
Martin JA, Park MM (1999) Trends in twins and triplets births: 1980-97. Nat Vit St Rep 47:12–16
National Center for Health Statistics (1993) Monthly vital statistics reports. Public Health Service. vol 41. Hyattsville, MD
Oleszczuk JJ, Keith DM, Keith LG, Rayburn WF (1999) Projecting twinning rates through the years 2100. J Rep Med 44:913–921
Olivennes F, Kadhel P, Rufat P, Fanchin R, Fernandez H, Frydman R (1996) Perinatal outcomes of twin pregnancies obtained after in vitro fertilization: comparison with twin pregnancies obtained spontaneously or after ovarian stimulation. Fertil Steril 66:105–109
Peipert JF, Bracken MB (1993) Maternal age: an independent risk factor for cesarean delivery. Obstet Gynecol 81:200–205
Rao A, Sairam S, Shehata H (2004) Obstetric complications of twin pregnancies. Best Pract Res Clin Obste Gynecol 18:557–576
Ruth J, Raino K (1988) Perinatal brain damage. Predictive value of metabolic acidosis and the Apgar score. Br Med J 297:24–28
Seidel MM (1988) A new era in reproductive terminology: in vitro fertilization, gamete intrafallopian transfer, and donated gametes and embryos. N Engl J Med 318:828–834
Society for Maternal-Fetal Medicine Ad-Hoc Research Task Force (2001) Research priorities in maternal-fetal medicine. Washington, DC: society for Maternal-Fetal Medicine
Ventura SJ, Martin JA, Curtin SC, Menacker F, Hamilton BE (2001) Births: final data for 1999. Nat Vit St Rep 49:3–10
Zhang J, Meike S, Grainger D, Trumble A (2002) Multifetal pregnancy in older women and perinatal outcomes. Fertil Steril 78:562–568
Zuppa AA, Maragliano G, Scapillari ME, Crescimbini B, Tortorolo G (2001) Neonatal outcomes of spontaneous and assisted twin pregnancies. Eur J Obstet Gynecol Rep Biol 95:68–72
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Prapas, N., Kalogiannidis, I., Prapas, I. et al. Twin gestation in older women: antepartum, intrapartum complications, and perinatal outcomes. Arch Gynecol Obstet 273, 293–297 (2006). https://doi.org/10.1007/s00404-005-0089-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00404-005-0089-8