Risk For Long-term Pediatric Morbidity Research Articles

723: Differences in long-term morbidities between the first and the second born twins.

Recent studies have reported an increased risk of short-term neonatal morbidity among second versus first-born twins in term and late preterm twin populations. The present study was aimed to investigate whether the second twins are also at an increased risk for long-term pediatric morbidity. In this population-based retrospective cohort study, the incidence of long-term (up to the age of 18 years) hospitalizations due to cardiovascular, neurological, respiratory, and infectious pediatric morbidities was investigated. A comparison was performed between the first and second born diamniotic twins. Deliveries occurred between the years 1991 and 2014 in a tertiary referral hospital. The risk for long-term morbidities in the twins was based on the hospital’s pediatric database and a pre-defined set of ICD-9 codes. Kaplan-Meier survival curves were constructed to compare cumulative morbidities and Cox proportional hazards models were used to control for confounders. In the current study 1919 sets of twins were inclucded. The total long-term hospitalizations, up to 18 years of age, due to cardiovascular (0.8% vs 0.6%, P=0.18), respiratory (4.0% vs 3.7%, P=0.29), neurologic (3.2% vs 3.6%, P=0.31) and infectious hospitalizations (7.5%% vs 7.5%, P=0.13) were comparable between the first and the second born twins (Table). Likewise, the Kaplan-Meier survival curves showed no difference in the cumulative incidence of total cardiovascular, respiratory, neurologic or infectious long-term hospitalizations between first and second born twins (Figure). In the Cox regression models adjusting for mode of delivery and gestational age, adjuted hazards ratios (aHR) were comparable between first and second born twin regarding cardiovascular (aHR=0.89, 95% CI 0.76-1.05, P=0.18), respiratory (aHR=1.01, 95% CI 0.94-1.06, P=0.91), neurological (aHR=1.21, 95% CI 0.84-1.74, P=0.30) or infectious morbidities (aHR=1.08, 95% CI 0.97-1.20, P=0.13). The second-born twin does not seem to be at an increased risk for long-term pediatric morbidity. Cumulative incidence of hospitalizations up to 18 years of age due to cardiovascular, neurological, respiratory, and infectious pediatric morbidities is comparable between the first and second born twin.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Maternal müllerian anomalies and future health of the offspring

ObjectiveTo evaluate whether offspring of women with müllerian anomalies are at an increased risk for long-term pediatric morbidity. Study designA population-based cohort study compared the incidence of long-term (up to the age of 18 years for offspring) hospitalizations due to cardiovascular, endocrine, neurological, hematological, respiratory and urinary morbidity of offspring to mothers diagnosed with uterine anomalies. Deliveries occurred between the years 1991 and 2013 in a tertiary medical center. Multiple pregnancies, unknown gestational age, gestational age of less than 24 weeks, perinatal mortality, and fetuses with congenital malformations were excluded. Kaplan–Meier survival curves were used to compare cumulative morbidity incidence. Survival analysis for clustered data was performed for each major-system pediatric hospitalization. ResultsDuring the study period 253,808 deliveries met the inclusion criteria; 0.48% (n=1230) of which occurred in women diagnosed with müllerian anomalies. In the Kaplan–Meier survival curve, children born to mothers with müllerian anomalies did not have a significantly different cumulative incidence of any of the long-term pediatric morbidities, compared with the comparison group. In the multivariable survival analysis for clustered data, after adjustment of maternal clusters, maternal age, gestational age and birthweight, müllerian anomalies did not exhibit an independent association with long-term morbidities of the offspring. ConclusionMüllerian anomalies do not appear to have an independent impact on long-term morbidity of the offspring.

361: Newborns with single umbilical artery delivered at term have an increased risk for long-term pediatric morbidity

361: Newborns with single umbilical artery delivered at term have an increased risk for long-term pediatric morbidity