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Obstetrics & Gynecology 2008;111:365-371
© 2008 by The American College of Obstetricians and Gynecologists
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ORIGINAL RESEARCH

Comparison of Singleton and Multiple-Birth Outcomes of Infants Born at or Before 32 Weeks of Gestation

Xiangming Qiu, MEd, PhD1,2, Shoo K. Lee, MBBS, PhD1,2, Kenneth Tan, MBBS, PhD3, Bruno Piedboeuf, MD, FRCPC4, Rody Canning, MB, FRCPC5 for the Canadian Neonatal Network*

From the Departments of Pediatrics, 1University of Alberta, Edmonton, Alberta; 2Integrated Centre for Care Advancement through Research (iCARE), Edmonton, Alberta; 3McMaster University, Hamilton, Ontario; 4Laval University, Quebec City, Quebec; and 5Moncton Hospital, Moncton, New Brunswick, Canada.

OBJECTIVE: To compare the outcomes of multiple-birth and singleton very preterm infants who were admitted to neonatal intensive care units (NICUs).

METHODS: Three-level hierarchical generalized linear and hierarchical linear model analyses were used to compare the risk-adjusted outcomes of 3,242 infants born at or before 32 weeks of gestational age who were admitted to 24 Canadian NICUs in 2005.

RESULTS: With the exception of respiratory distress syndrome (RDS), multiple-birth infants were not at a higher risk than singleton birth infants for death, patent ductus arteriosus, necrotizing enterocolitis, chronic lung disease, severe intraventricular hemorrhage, severe (stages 3 or higher) retinopathy of prematurity, or nosocomial infection, after adjusting for perinatal risks and neonatal illness severity. In addition, multiple-birth infants did not have a more prolonged duration of neonatal intensive care unit stay, duration of length of continuous positive airway pressure use, duration of ventilation, or duration of oxygen use than did singletons. Multiple-birth infants had a higher incidence of RDS (adjusted odds ratio 1.3, 95% confidence interval 1.0–1.6) and a lower incidence of severe retinopathy of prematurity (adjusted odds ratio 0.5, 95% confidence interval 0.3–0.9) than did singletons.

CONCLUSION: Multiple-birth and singleton very preterm infants had similar outcomes, except for a higher incidence of RDS among multiple-birth infants.

LEVEL OF EVIDENCE: II






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