Prevalence of respiratory distress syndrome in premature twins compared to premature singletons

Abstract

Aim To estimate prevalence of respiratory distress syndrome in preterm twins compared to preterm singletons. Methods This is a retrospective observational point prevalence study conducted at the level of three neonatal intensive care units. Medical records of all preterm newborns (<37 weeks of gestation) with respiratory distress syndrome treated in a two-year period were reviewed. The birth order of twins, gestational age and mortality were analyzed.Results Out of 809 preterm newborns, 104 (12.9%) were twins. Median gestational age at birth was 30.3 (IQR 31.4–34.2) weeks. Respiratory distress syndrome was diagnosed in 525 (64.9 %) preterm newborns, of which 441 singletons and 84 twins. Prevalence of respiratory distress syndrome in first-born twins was not significantly higher compared with singletons, 67.3% (35/52) vs. 62.6 % (441/705), respectively (p=0.06). Prevalence of respiratory distress syndrome in second-born twins was 94.2 % (49/52), which was significantly higher compared with both singletons and first-born twins (p<0.001). The mortality rate of preterm newborns was significantly higher in second-born twins compared with singletons and first-born twins, 15.4 % vs. 6.8 %  (p<0.001) and 15.4 % vs. 5.5% (p<0.001), respectively. Conclusion There was a higher risk of respiratory distress syndrome and higher mortality rate in twins compared with singletons, but only in second-born twins the difference was statistically significant.

Keywords

• preterm birth
• res-piratory distress syndrome
• twin pregnancy