Hiroyuki Tsuda1, Tomomi Kotani2, Tomoko Nakano2, Kenji Imai2, Takafumi Ushida2, Akihiro Hirakawa3, Fumie Kinoshita3, Yuichiro Takahashi4, Shigenori Iwagaki4, Fumitaka Kikkawa2. 1. Department of Obstetrics and Gynecology, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya, Japan; Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan. Electronic address: hirotty7099@yahoo.co.jp. 2. Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan. 3. Biostatics Laboratory, Nagoya University Graduate School of Medicine, Nagoya, Japan. 4. Department of Fetal and Maternal Medicine, Nagara Medical Center, Gifu City, Japan.
Abstract
BACKGROUND: Whether or not the period of fetal lung maturity differs between twin and singleton pregnancies has not been clarified. We examined whether or not fetal lung maturity and fetal lung absorption are achieved earlier in twin fetuses than in singleton fetuses. METHODS: We registered 454 singleton pregnancies and 398 twin pregnancies with no congenital abnormalities affecting the respiratory function or neonatal deaths. All patients were delivered by Caesarean section without labor between 24 and 38 gestational weeks. The amniotic fluid samples were analyzed immediately without centrifugation. A multiple logistic regression analysis was performed to explore the relationship between twin pregnancy and neonatal respiratory distress syndrome and transient tachypnea of the newborn (RDS/TTN). RESULTS: The rate of RDS/TTN in infants was significantly higher and the lamellar body counts (LBCs) significantly lower in singleton pregnancies than that in twin pregnancies (P < .001). According to a multivariate logistic regression analysis, twin pregnancy (odds ratio, 0.34; 95% confidence interval, 0.22-0.55) was a significant preventive factor for neonatal RDS/TTN. CONCLUSIONS: We showed that twin fetuses experience more rapid lung maturation and lung fluid absorption than singleton fetuses, as confirmed by the higher LBC values in twin fetuses.
BACKGROUND: Whether or not the period of fetal lung maturity differs between twin and singleton pregnancies has not been clarified. We examined whether or not fetal lung maturity and fetal lung absorption are achieved earlier in twin fetuses than in singleton fetuses. METHODS: We registered 454 singleton pregnancies and 398 twin pregnancies with no congenital abnormalities affecting the respiratory function or neonatal deaths. All patients were delivered by Caesarean section without labor between 24 and 38 gestational weeks. The amniotic fluid samples were analyzed immediately without centrifugation. A multiple logistic regression analysis was performed to explore the relationship between twin pregnancy and neonatal respiratory distress syndrome and transient tachypnea of the newborn (RDS/TTN). RESULTS: The rate of RDS/TTN in infants was significantly higher and the lamellar body counts (LBCs) significantly lower in singleton pregnancies than that in twin pregnancies (P < .001). According to a multivariate logistic regression analysis, twin pregnancy (odds ratio, 0.34; 95% confidence interval, 0.22-0.55) was a significant preventive factor for neonatal RDS/TTN. CONCLUSIONS: We showed that twin fetuses experience more rapid lung maturation and lung fluid absorption than singleton fetuses, as confirmed by the higher LBC values in twin fetuses.