Abstract
ObjectiveTo evaluate not only the risk of total preterm birth (PTB) but also spontaneous preterm birth (sPTB) and indicated preterm birth (iPTB) in vanishing twin (VT).Study designThis is a secondary analysis of a multicenter prospective cohort study. In 12 different healthcare institutions, women with singleton pregnancies were enrolled in early pregnancy and followed up till delivery.ResultsA total of 4,746 women were included in the final analysis, and. the frequency of VT was 1.1% (54/4746). VT group had a higher risk for total PTB (PTB<34 weeks, 2.1% vs. 14.8%, p<0.001; PTB<32 weeks, 1.6% vs. 13.0%, p<0.001; PTB<28 weeks, 0.9% vs. 13.0%, p<0.001) than singleton group. The VT group had increased risk for both sPTB and iPTB (<34 weeks, <32 weeks, and <28 weeks), and this increased risk for sPTB and iPTB in VT group remained significant even after controlling for confounders such as maternal age, parity, pre-pregnancy BMI, and mode of conception.ConclusionVanishing twin can be an independent risk factor for both sPTB and iPTB when compared with singleton pregnancy.
Highlights
The “vanishing twin” is diagnosed when one twin “vanishes” or is lost in the first trimester
vanishing twin (VT) group had a higher risk for total preterm birth (PTB) (PTB
Vanishing twin can be an independent risk factor for both spontaneous preterm birth (sPTB) and indicated spontaneous preterm birth (iPTB) when compared with singleton pregnancy
Summary
The “vanishing twin” is diagnosed when one twin “vanishes” or is lost in the first trimester. The prevalence of vanishing twin is reported up to 10 to 40 percent among twin pregnancies [1, 2]. The etiology of vanishing twin is still uncertain, and its exact prevalence is not well-known because ultrasonography at first trimester is not always possible in a clinical situation. It was believed that this vanishing twin phenomenon do not affect the pregnancy outcomes of the remained co-twin [4]. A few recent studies described adverse obstetric outcomes such as preterm birth and low birth weight in vanishing twin [5,6,7,8,9], whereas other studies did not find differences between singleton pregnancy and vanishing twin [7, 10, 11]. There is a paucity of information regarding the risk of spontaneous preterm birth (sPTB) and indicated spontaneous preterm birth (iPTB) it is plausible that vanishing twin might increase the risk of sPTB by an inflammatory condition [12]
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