Prematurity and twinning

Aim of the study: Newborns from multiple pregnancies are increasing in number and demonstrate a higher perinatal morbidity and mortality compared to singletons. Prematurity is the main reason for most neonatal diseases in twins, but other variables may play a role and their prenatal evaluation may improve the overall outcome. Main findings: Prematurity is six times more frequent in twins and therefore birth weight is significantly lower compared to singletons. Thus, twins are more exposed to prematurity related diseases (respiratory, cardiovas- cular, infectious, etc.) and to long-term complications (especially neurological disabilities). Results: It is very difficult to estimate the increased risk of neonatal morbidity related to twinning independently to the increased risk of prematurity and there- fore to interpret data on morbidity rates, in particular regarding the neurodevelopmental outcome. Conclusion: Prevention of preterm birth is a primary goal in managing multiple pregnan- cies, together with prophylaxis with corticosteroids in order to improve foetal lung maturity. Accurate risk assessment strate- gies and adequate obstetrical-neonatological management of multiple pregnancies may reduce the increasing need for neonatal intensive care and for health resources in the long-term follow-up that has been observed over the last decades.