Specialized prenatal care and maternal and infant outcomes in twin pregnancy

Am J Obstet Gynecol. 2003 Oct;189(4):934-8. doi: 10.1067/s0002-9378(03)01054-8.

Abstract

Objective: This study was undertaken to evaluate the effect of a prenatal nutrition and education program on twin pregnancy, neonatal, and early childhood outcomes.

Study design: This prospective intervention study of women who participated in a specialized program (Program Pregnancies) versus nonparticipants included twice-monthly visits, dietary prescription of 3000 to 4000 kcal per day, multimineral supplementation, and patient education.

Results: Program Pregnancies were associated with improved pregnancy outcomes (preeclampsia, adjusted odds ratio [AOR] 0.41, 95% CI, 0.23-0.75; preterm premature rupture of membranes, AOR 0.35, 95% CI, 0.20-0.60; delivery <36 weeks, AOR 0.62, 95% CI, 0.43-0.89; low birth weight, AOR 0.42, 95% CI, 0.29-0.61), significantly longer gestations (+7.6 days), higher birth weights (+220 g), lower neonatal morbidity (retinopathy of prematurity, necrotizing enterocolitis, intraventricular hemorrhage, or ventilator support, AOR 0.44, 95% CI, 0.31-0.62), length of stay (-5.3 days), and cost per twin (-14,023 dollars). Through 3 years of age, program children were significantly less likely to be rehospitalized (AOR 0.31, 95% CI, 0.11-0.91) or to be developmentally delayed (AOR 0.65, 95% CI, 0.44-0.96).

Conclusion: Program participation was associated with improved outcomes at birth and through age 3 years.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Birth Weight
  • Child, Preschool
  • Female
  • Growth
  • Humans
  • Infant
  • Infant Mortality
  • Infant, Newborn
  • Nutritional Sciences / education
  • Obstetric Labor, Premature
  • Odds Ratio
  • Patient Education as Topic
  • Pregnancy
  • Pregnancy Outcome*
  • Pregnancy, Multiple*
  • Prenatal Care / standards*
  • Prospective Studies
  • Risk Factors
  • Twins