Comparison of perinatal outcome of late preterm premature rupture of membranes in twin and singleton pregnancies

초록

Objectives This study aimed to compare perinatal outcomes of preterm premature rupture of membranes between twin and singleton pregnancy in late preterm period. Methods This retrospective case-control study included women with preterm birth followed by PPROM from 33+0-36+6 weeks of gestation who delivered at Korea University Ansan Hospital from July 2006 to October 2020. We analysed and compared maternal and neonatal characteristics and neonatal morbidity and mortality between twin and singleton pregnancies. Neonatal outcomes between 1st and 2nd twin babies were compared. Results Total of four hundred twenty-five women with preterm birth followed by PPROM were analysed. There were 59 twin pregnancies and 366 singleton pregnancies. There were no significant differences between the two groups in maternal age, gestational age at delivery, maternal BMI, use of tocolytics, antibiotics and steroid, WBC and neutrophil count. Latency was significantly longer and the rate of oligohydramnios was less common in twin pregnancies. Hospital days were significantly longer and the rate of any of the respiratory support, resuscitation, and use of a non-invasive ventilator were significantly higher in the 2nd baby of a twin compared to the 1st baby of a twin and singleton baby. At each 33 and 34 weeks of gestation, 2nd baby of a twin had more respiratory problems than 1st twin after adjustment. Conclusions 2nd baby of a twin with late PPROM was associated with more acute respiratory problems and longer hospital days compared to 1st twin and singleton baby. More cautious respiratory care is needed for 2nd baby right after birth.