Preterm infants of multiple gestations, which comprise approximately 20% of NICU admissions, have been reported to be at increased risk of adverse outcomes.

Hypothesis: Outcomes at age 120 days of 24 to 27 weeks gestation twins are similar to singletons of the same gestation.

Methods: The Network registry (501 to 1500 grams) was used to determine risk-adjusted outcomes of 24 to 27 week twins and singletons. Paired twins (n=648) and singletons (n=3703) were included. Infants greater than 28 wks gestation were excluded because the registry uses a 1500 gram birth weight inclusion cutoff which disproportionately selects small for gestational age(SGA) infants at the higher gestations. Generalized Estimating Equations were used to evaluate the risk of death and death or major morbidity (chronic lung disease [CLD] or grade III/IV intracranial hemorrhage [ICH]). Independent variables found to be significant in univariate analyses were included in the models.

Results: Mothers of twins were more likely to be non-Black (51 v 43%), experience labor (89 v 83%), receive antenatal steroids (28 v 22%) and deliver by C-section (46 v 37%). Twins were more likely to receive surfactant(76 v 62%); and a greater proportion of twins were SGA compared to singletons(12 v 9%, X2, p=0.043). Table

Table 1
Full size table

Conclusions: Despite a small increased risk of growth retardation, both first and second born twins, who are 24 to 27 weeks gestation and cared for in neonatal intensive care units, have similar risks of death and major morbidity compared to singletons of the same gestation.