TY - JOUR
T1 - Trends in preterm birth in twin pregnancies in Victoria, Australia, 2007–2017
AU - Burger, Renée J.
AU - Temmink, Sofieke
AU - Wertaschnigg, Dagmar
AU - Ganzevoort, Wessel
AU - Reddy, Maya
AU - Davey, Mary-Ann
AU - Wallace, Euan Morrison
AU - Mol, Ben-Willem
N1 - Funding Information: We are grateful to Consultative Council on Obstetric and Paediatric Mortality and Morbidity (CCOPMM) for providing access to the data used for this project and for the assistance of the staff at Safer Care Victoria. The conclusions, findings, opinions and views or recommendations expressed in this paper are strictly those of the author(s). They do not necessarily reflect those of CCOPMM. No financial or material support was received for this study. BWM is supported by a National Health and Medical Research Council (NHMRC) Investigator Grant (GNT1176436). EMW is supported by a NHMRC Program Grant (APP1113902) and a Partnership Grant (APP1151853). DW is supported by a grant from the Paracelsus Medical University Salzburg, Austria (PMU Research Fund – PMU FFF Number: L‐18/02/006‐WET). Funding Information: We are grateful to Consultative Council on Obstetric and Paediatric Mortality and Morbidity (CCOPMM) for providing access to the data used for this project and for the assistance of the staff at Safer Care Victoria. The conclusions, findings, opinions and views or recommendations expressed in this paper are strictly those of the author(s). They do not necessarily reflect those of CCOPMM. No financial or material support was received for this study. BWM is supported by a National Health and Medical Research Council (NHMRC) Investigator Grant (GNT1176436). EMW is supported by a NHMRC Program Grant (APP1113902) and a Partnership Grant (APP1151853). DW is supported by a grant from the Paracelsus Medical University Salzburg, Austria (PMU Research Fund ? PMU FFF Number: L-18/02/006-WET). Funding Information: BWM is supported by a NHMRC Investigator Grant (GNT1176436). EMW is supported by a NHMRC Program Grant (APP1113902) and a Partnership Grant (APP1151853). DW is supported by a grant from the Paracelsus Medical University Salzburg, Austria (PMU Research Fund – PMU FFF Number: L‐18/02/006‐WET). The author(s) received no financial support for the research, authorship, and/or publication of this article. Publisher Copyright: © 2020 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/2
Y1 - 2021/2
N2 - Background: Preterm birth is a major cause of perinatal morbidity and mortality worldwide. In many countries, the preterm birth rate in women with a multiple pregnancy is increasing, mostly due to an increase in iatrogenic preterm birth. Aims: To investigate trends in preterm birth in twin pregnancies in Victoria, Australia, in relation to maternal and perinatal complications. Materials and methods: We conducted a retrospective population-based cohort study in all women with a twin pregnancy who delivered at or after 20 weeks of gestation in the state of Victoria, Australia between 2007 and 2017. Annual spontaneous and iatrogenic preterm birth rates were calculated and trends analysed. Incidence of adverse pregnancy outcomes, maternal complications and risk factors for preterm birth were analysed. Results: We studied 12 757 women with a twin pregnancy. Between 2007 and 2017 the preterm birth rate increased from 641/1231 (52%) to 803/1158 (69%), mainly due to an increase in iatrogenic preterm birth from 342/1231 (28%) to 567/1158 (49%). This was irrespective of the presence of pregnancy complications. Our study showed neither a decrease in perinatal mortality from 28 weeks of gestation nor in preterm average weekly prospective stillbirth risk. Conclusion: Preterm birth rates in twins in Victoria are increasing, mainly driven by an increase in iatrogenic preterm birth. This occurred both in complicated and non-complicated twin pregnancies, and has not been accompanied by reduction in perinatal mortality from 28 weeks.
AB - Background: Preterm birth is a major cause of perinatal morbidity and mortality worldwide. In many countries, the preterm birth rate in women with a multiple pregnancy is increasing, mostly due to an increase in iatrogenic preterm birth. Aims: To investigate trends in preterm birth in twin pregnancies in Victoria, Australia, in relation to maternal and perinatal complications. Materials and methods: We conducted a retrospective population-based cohort study in all women with a twin pregnancy who delivered at or after 20 weeks of gestation in the state of Victoria, Australia between 2007 and 2017. Annual spontaneous and iatrogenic preterm birth rates were calculated and trends analysed. Incidence of adverse pregnancy outcomes, maternal complications and risk factors for preterm birth were analysed. Results: We studied 12 757 women with a twin pregnancy. Between 2007 and 2017 the preterm birth rate increased from 641/1231 (52%) to 803/1158 (69%), mainly due to an increase in iatrogenic preterm birth from 342/1231 (28%) to 567/1158 (49%). This was irrespective of the presence of pregnancy complications. Our study showed neither a decrease in perinatal mortality from 28 weeks of gestation nor in preterm average weekly prospective stillbirth risk. Conclusion: Preterm birth rates in twins in Victoria are increasing, mainly driven by an increase in iatrogenic preterm birth. This occurred both in complicated and non-complicated twin pregnancies, and has not been accompanied by reduction in perinatal mortality from 28 weeks.
KW - Female
KW - Humans
KW - Infant, Newborn
KW - Pregnancy
KW - Pregnancy Outcome/epidemiology
KW - Pregnancy, Twin
KW - Premature Birth/epidemiology
KW - Retrospective Studies
KW - Victoria/epidemiology
UR - http://www.scopus.com/inward/record.url?scp=85089579863&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/ajo.13227
DO - https://doi.org/10.1111/ajo.13227
M3 - Article
C2 - 32820556
SN - 0004-8666
VL - 61
SP - 55
EP - 62
JO - Australian & New Zealand journal of obstetrics & gynaecology
JF - Australian & New Zealand journal of obstetrics & gynaecology
IS - 1
ER -