Abstract:
BACKGROUND:There are limited data on how maternal age is related to twin pregnancy outcomes. OBJECTIVE:The purpose of this study was to assess the relationship between maternal age and risk for preterm birth, fetal death, and neonatal death in the setting of twin pregnancy. STUDY DESIGN:This population-based study of US birth, fetal death, and period-linked birth-infant death files from 2007-2013 evaluated neonatal outcomes for twin pregnancies. Maternal age was categorized as 15-17, 18-24, 25-29, 30-34, 35-39, and ≥40 years of age. Twin live births and fetal death delivered at 20-42 weeks were included. Primary outcomes included preterm birth (<34 weeks and <37 weeks), fetal death, and neonatal death at <28 days of life. Analyses of preterm birth at <34 and <37 weeks were adjusted for demographic and medical factors, with maternal age modeled with the use of restricted spline transformations. RESULTS:A total of 955,882 twin live births from 2007-2013 were included in the analysis. Preterm birth rates at <34 and <37 weeks gestation were highest for women 15-17 years of age, decreased across subsequent maternal age categories, nadired for women 35-39 years old, and then increased slightly for women ≥40 years old. Risk for fetal death generally decreased across maternal age categories. Risk for fetal death was 39.9 per 1000 live births for women 15-17 years old, 24.2 for women 18-24 years old, 17.8 for women 25-29 years old, 16.4 for women 30-34 years old, 17.2 for women 35-39 years old, and 15.8 for women ≥40 years old. Risk for neonatal death at <28 days was highest for neonates born to women 15-17 years old (10.0 per 1,000 live births), decreased to 7.3 for women 18-24 years old and 5.5 for women 25-29 years old and ranged from 4.3-4.6 for all subsequent maternal age categories. In adjusted models, risk for preterm birth at <34-<37 weeks gestation was not elevated for women in their mid-to-late 30s; however, risk was elevated for women <20 years old and increased progressively with age for women in their 40s. CONCLUSION:Although twin pregnancy is associated with increased risk for most adverse perinatal outcomes, this analysis did not find advanced maternal age to be an additional risk factor for fetal death and infant death. Preterm birth risk was relatively low for women in their late 30s. Risks for adverse outcomes were higher among younger women; further research is indicated to improve outcomes for this demographic group. It may be reasonable to counsel women in their 30s that their age is not a major additional risk factor for adverse obstetric outcomes in the setting of twin pregnancy.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
McLennan AS,Gyamfi-Bannerman C,Ananth CV,Wright JD,Siddiq Z,D'Alton ME,Friedman AMdoi
10.1016/j.ajog.2017.03.002subject
Has Abstractpub_date
2017-07-01 00:00:00pages
80.e1-80.e8issue
1eissn
0002-9378issn
1097-6868pii
S0002-9378(17)30413-1journal_volume
217pub_type
杂志文章abstract::Congenital cytomegalovirus (CMV) is the most common viral infection, affecting nearly 40,000 infants each year in the United States. Of seronegative women, 1-4% will acquire a primary infection during pregnancy, and the majority of these women will be asymptomatic. Prior maternal exposure to CMV does not preclude neon...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.ajog.2016.02.042
更新日期:2016-06-01 00:00:00
abstract::Components of fetal behavioral state organization reflect the successful integration of the central nervous system, have a specific developmental timetable, and can be studied with fetal ultrasonographic techniques. To test the hypothesis that evaluation of state organization is a marker of abnormal central nervous sy...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(89)90380-3
更新日期:1989-09-01 00:00:00
abstract:OBJECTIVE:We evaluated the use of the harmonic scalpel in reducing the occurrence of symptomatic lymphoceles and its related complications in paraaortic laparoscopic lymphadenectomies (PALLs). STUDY DESIGN:All PALL that were performed at the Institut Claudius Regaud between January 2003 and June 2007 were included. Si...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2009.05.026
更新日期:2009-10-01 00:00:00
abstract::Fetal gender was prospectively determined by ultrasonography in 115 patients with singleton pregnancies between 16 and 20 weeks of gestation. Gender determination was performed as a part of the sonographic examination preceding genetic amniocentesis, and the results were compared to the amniotic fluid fetal karyotype ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(87)90055-x
更新日期:1987-03-01 00:00:00
abstract::One or more infants of a multifetal pregnancy occasionally require delivery selectively because of in utero risk of fetal death in circumstances in which the sibling fetus appears well. At 26 weeks 5 days of gestation a small fundally placed twin in a dichorionic gestation had an estimated fetal weight of 650 g with d...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(98)70285-6
更新日期:1998-07-01 00:00:00
abstract:OBJECTIVE:Our purpose was to determine the effect of in utero exposure to indomethacin on the need for surgical closure of a patent ductus arteriosus (PDA). STUDY DESIGN:Perinatal variables were compared between infants at <32 weeks who required surgical closure of PDA after failed medical management and those who did...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2002.127464
更新日期:2002-10-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to assess the usefulness of a new platelet function analyzer in the detection of von Willebrand disease and platelet dysfunction in women with menorrhagia. STUDY DESIGN:Women with menorrhagia and control subjects were tested with a platelet function analyzer. If the results were...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2004.03.009
更新日期:2004-08-01 00:00:00
abstract:OBJECTIVE:Our goal was to determine whether laparoscopic salpingostomy is preferable to laparoscopic methotrexate injection in the management of unruptured tubal gestation. STUDY DESIGN:Forty-eight patients with unruptured tubal pregnancy were prospectively randomized to either laparoscopic salpingostomy or laparoscop...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1053/ob.1996.v175.a74249
更新日期:1996-09-01 00:00:00
abstract::In responsive tissues the induction of 25-hydroxycholecalciferol 24-hydroxylase activity is a marker of 1,25-dihydroxycholecalciferol action. In this study we investigated the responsiveness of various malignant cells, which were derived from carcinomas of gynecologic origin, to 1,25-dihydroxycholecalciferol; we did s...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(86)90162-6
更新日期:1986-12-01 00:00:00
abstract:OBJECTIVE:Classic radioligand binding techniques have suggested that beta 1- and beta 2-adrenergic receptor subtype proteins are expressed in myometrial tissue; however, to date these observations have not been confirmed at the level of the messenger ribonucleic acid for these clinically important membrane receptors. T...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(97)70497-6
更新日期:1997-02-01 00:00:00
abstract:BACKGROUND:Congophilia indicates the presence of amyloid protein, which is an aggregate of misfolded proteins, that is implicated in the pathophysiologic condition of preeclampsia. Recently, urinary congophilia has been proposed as a test for the diagnosis and prediction of preeclampsia. OBJECTIVES:The purpose of this...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2016.04.041
更新日期:2016-10-01 00:00:00
abstract:OBJECTIVE:In 2005, 4 Clostridium sordellii-associated toxic shock fatalities were reported in young Californian women after medical abortions. The true incidence of this rare disease is unknown, and a population-based study has never been performed. Additional clostridia-associated deaths were sought to describe associ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2009.05.023
更新日期:2009-11-01 00:00:00
abstract::The source of amniotic fluid prolactin was investigated with the use of amnion, chorion, placenta, and decidual tissue taken from term human pregnancy. Decidua alone of these tissues contained significant quantities of prolactin. The release of decidual prolactin was affected by the presence or absence of oxygen and p...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(16)33248-3
更新日期:1977-01-15 00:00:00
abstract:OBJECTIVE:The purpose of this study was to compare the performance of first-trimester nuchal translucency (NT) cutoff of ≥3.5 mm with NT percentiles that were calculated for crown-rump length to identify fetuses with critical congenital heart defects (CCHDs). STUDY DESIGN:This was a population-level study of singleton...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2014.10.1102
更新日期:2015-04-01 00:00:00
abstract::The progesterone antagonist onapristone was used in guinea pigs during late pregnancy (43 +/- 2 days after coitus) and before term (day 61 after coitus) to investigate the role of progesterone on uterine reactivity to exogenous oxytocin, concentration of oxytocin receptors, and gap junctions in the myometrium. Onapris...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(91)90030-u
更新日期:1991-12-01 00:00:00
abstract:OBJECTIVES:This study was carried out to determine the distribution of maternal-fetal medicine (MFM) subspecialists and to profile MFM subspecialists' (1) target patient populations, (2) practice organization, (3) workloads, (4) services provided, and (5) job satisfaction. STUDY DESIGN:The membership of the Society fo...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2001.119719
更新日期:2001-11-01 00:00:00
abstract::Right and left ventricular outputs were measured continuously in fetal lambs in utero for 2 to 21 days after implantation of electromagnetic flow tranducers around the main pulmonary trunk and ascending aorta. Surface pacing electrodes were implanted on the left and right atria. The intact cervical vagus nerve was sti...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(16)33296-3
更新日期:1976-01-15 00:00:00
abstract:OBJECTIVE:The purpose of this study was to summarize 3 recent high-profile infectious disease threats that have affected the United States: severe acute respiratory syndrome, West Nile virus, and anthrax. STUDY DESIGN:A systematic review was conducted with the use of Medline searches, searches of the Centers for Disea...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.ajog.2005.06.062
更新日期:2006-06-01 00:00:00
abstract::Twenty-six pregnant women were given prophylactic heparin treatment because of previous thromboembolic complications. The mean duration of treatment was 25 weeks (range, 6 to 32 weeks). The amount of heparin was adjusted to a plasma concentration of 0.08 to 0.15 IU/ml, measured as anti-factor Xa activity. This effect ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(89)90535-8
更新日期:1989-08-01 00:00:00
abstract:OBJECTIVE:The efficacy, safety, and antibiotic-related charges for once-daily gentamicin with twice-daily clindamycin were compared with those of thrice-daily dosing of these antibiotics. STUDY DESIGN:Patients with puerperal endometritis or with chorioamnionitis in labor assessed to be at risk for endometritis were ra...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1997-10-01 00:00:00
abstract::Universal access to contraception benefits society: unintended pregnancies, maternal mortality, preterm birth, abortions, and obesity would be reduced by increasing access to affordable contraception. Women should be able to choose when and whether to use contraception, choose which method to use, and have ready acces...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2019.09.014
更新日期:2020-02-01 00:00:00
abstract::Blue rubber bleb nevus syndrome is a disorder characterized by cutaneous and visceral venous malformations with a potential for life-threatening hemorrhage. Only 3 reports of blue rubber bleb nevus syndrome in pregnant women can be found by a Medline search. We present our experience in the management of this rare con...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2008.01.028
更新日期:2008-07-01 00:00:00
abstract::Four epidemiologic studies showed a twofold increase in risk of deep venous thrombosis with the use of oral contraceptives containing third-generation progestins, relative to second-generation products. These findings have been strongly debated ever since, and new studies have been added. In the current article we exa...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/s0002-9378(97)70289-8
更新日期:1997-10-01 00:00:00
abstract::Fecundity has been extended to the menopause by advances in assisted reproductive techniques. The incidence of ovarian cancer increases with age, and an increased risk of ovarian cancer has been associated with incessant ovulation and infertility. The increased risk of ovarian cancer in older infertility patients must...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(94)90164-3
更新日期:1994-11-01 00:00:00
abstract::The regional distribution of cerebral blood flow was assessed in eight control and eight morphometrically growth-retarded fetal lambs to determine whether perfusion patterns within the cerebral circulation are altered in this model of intrauterine growth retardation. Growth retardation was induced by repetitive emboli...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(84)90460-5
更新日期:1984-12-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to investigate vascular reactivity in heterozygous and homozygous offspring with a genetic predisposition for hypertension after postnatal cross-fostering to mothers with the opposite genetic inheritance of the NOS3 knockout allele. STUDY DESIGN:Homozygous NOS3 knockout (C57BL/6...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2007.01.031
更新日期:2007-04-01 00:00:00
abstract::The presence of fetal breathing, even if episodic in character, may not indicate fetal well being. In a study of fetal lambs with long-term implantation of catheters and electrodes, five of six lambs which died before the onset of labor had terminal episodes of continuous breathing, preceded by 4 1/4 to 45 1/2 hours o...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(16)33138-6
更新日期:1978-08-15 00:00:00
abstract:OBJECTIVES:Our goals were (1) to determine whether hypertension, proteinuria, and glomerular endotheliosis can be produced by chronic reduction of lower aortic pressure in pregnant rhesus monkeys and (2) to study the time course of the development of hypertension by means of longitudinal arterial blood pressure measure...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(93)90171-e
更新日期:1993-07-01 00:00:00
abstract::A total of 1,755 fetal heart rate (FHR) tracings of the second stage of labor was analyzed. The FHR patterns were classified according to the behavior of the baseline FHR and are listed in decreasing order of benignity: normocardia, transitory bradycardia, tachycardia, persistent bradycardia, and progressive bradycard...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(81)90041-7
更新日期:1981-06-15 00:00:00
abstract:BACKGROUND:Preterm premature rupture of membranes complicates 2-3% of pregnancies. Many institutions have advocated for the use of azithromycin instead of erythromycin. This is secondary to national shortages of erythromycin, ease of administration, better side effect profile, and decreased cost of azithromycin as comp...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ajog.2019.03.009
更新日期:2019-08-01 00:00:00