Contribution of Gestational Age and Birth Weight to Perinatal Viability in Singletons Versus Twins

Abstract

The objective of this study was to determine the effects of birth weight and gestational age on twin vs. singleton mortality. Population-based analysis of live births, fetal deaths, and infant deaths by plurality in the United States from 1983 to 1986 was conducted. Seven mortality rates and relative risks (RRs) of twin vs. singleton mortality were calculated by birth weight, gestational age, and combined birth weight and gestational age. The mortality rates included fetal, perinatal, early neonatal, late neonatal, neonatal, postneonatal, and infant. Twins had 3–4 times the RRs of mortality compared to singletons, ranging from a RR of 2.71 for postneonatal mortality to a RR of 3.73 for late neonatal mortality. Generally, for birth weights of 2,800 g or less and gestational ages of 38 weeks or less, twins had lower combined birth weight and gestational age mortality rates and lower RRs. Between 1,900 and 2,799 g, mortality rates decreased then increased with advancing gestation between 31 and 42 weeks both...