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Hum. Reprod. Advance Access published online on June 10, 2008
Human Reproduction, doi:10.1093/humrep/den134
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© The Author 2008. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Perinatal outcome of twin pregnancies in women of advanced age

Ilse Delbaere1,6, Hans Verstraelen1, Sylvie Goetgeluk2, Guy Martens3, Catherine Derom4, Dirk De Bacquer5, Guy De Backer5 and Marleen Temmerman1

1 Department of Obstetrics and Gynaecology, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent, Belgium 2 Department of Applied Mathematics and Informatics, Ghent University, Ghent, Belgium 3 Study Centre for Perinatal Epidemiology, Brussels, Belgium 4 Department of Human Genetics, Katholieke Universiteit Leuven, Leuven, Belgium 5 Department of Public Health, Ghent University, Ghent, Belgium

6 Correspondence address. Tel: +32-9-240-48-53; Fax: +32-9-240-38-31; E-mail: ilse.delbaere{at}ugent.be

BACKGROUND: The aim of this study was to assess the outcome of twin pregnancies in women of advanced age (≥35 years) compared with women aged 25–29 years old.

METHODS: This population-based retrospective study compared perinatal outcome of twin pregnancies in primiparae aged 35 or older (N = 240) to that of twin pregnancies in primiparae aged 25–29 years (N = 940). Observed outcomes are adjusted for intermediate (mode of conception and hypertension during pregnancy) and confounding variables (level of education). The possible effect of zygosity and chorionicity was tested in a subset of this database, recorded in the East Flanders Prospective Twin Survey (EFPTS).

RESULTS: In twin pregnancies, maternal age of 35 or over is associated with a lower incidence of preterm birth [adjusted odds ratio (AOR) 0.59, 95% confidence interval (CI) 0.44–0.79] and low birthweight (AOR 0.75, 95% CI 0.58–0.98) compared with younger women. Differences in zygosity and chorionicity between both cohorts do not seem to affect the result.

CONCLUSIONS: In comparison with primiparae aged 25–29 years, perinatal outcome of twin pregnancies is more favourable in primiparae aged 35 or over.

Key words: multiple pregnancy/advanced maternal age/pregnancy outcome/ART/zygosity

Submitted on December 19, 2007; resubmitted on March 13, 2008; accepted on March 25, 2008.


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