Primiparity, assisted reproduction, and preterm birth in twin pregnancies: A population based study

Offer Erez, Amit Mayer, Ilana Shoham-Vardi, Doron Dukler, Moshe Mazor

    Research output: Contribution to journalArticlepeer-review

    17 Scopus citations


    Objective: To determine the prevalence of pregnancy complications among primiparous patients with twin gestation in our population and to investigate the association between the increased rates of assisted reproduction (ART) in twin gestation and preterm birth (PTD). Material and methods: A retrospective population based cohort study was designed, including all twin deliveries after 24 weeks gestation (n = 2,601). The study group included 666 primiparous women and the comparison group 1,935 multiparous women. Maternal characteristics and perinatal outcome were evaluated. Women with fetal malformations were excluded. A multiple logistic regressions analysis for independent risk factors was performed including factors that were significantly different between the study groups in the univariate analysis. Patient's data were obtained from computerized database and analyzed using SPSS statistical package. Results: Primiparous women had a significantly higher rate of preeclampsia, chronic hypertension, ART, prelabor rupture of membranes (PROM) preterm deliveries (PTD), labor dystocia, cesarean section (CS) and vacuum extraction of the first twin than the multiparous group. Primiparous patients had a significantly lower gestational age at delivery and neonatal birth weight of the first and second twin. In multiple logistic regressions analysis primiparity and ART were independent risk factors for PTD, (OR 1.45, 95% CI 1.18-1.78; OR 1.36, 95% CI 1.09-1.71, respectively). Conclusions: (1) Primiparous patients with twin gestation represent a unique population with high rate of infertility and underlying diseases such as chronic hypertension in comparison to the multiparous women with twin gestation; (2) primiparity is an independent risk factor for prematurity in twin gestations; and (3) although primiparous women had an increased maternal complications, neonatal mortality rates were not significantly different from multiparous women.

    Original languageEnglish
    Pages (from-to)311-317
    Number of pages7
    JournalArchives of Gynecology and Obstetrics
    Issue number4
    StatePublished - 1 Apr 2008


    • IVF
    • Multiple pregnancy
    • Parity
    • Preterm delivery
    • Primiparous
    • Twins

    ASJC Scopus subject areas

    • Obstetrics and Gynecology


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