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Impact of sex on perinatal mortality and morbidity in twins

  • Emma Elsmén Steen EMAIL logo , Karin Källén , Karel Maršál , Mikael Norman and Lena Hellström-Westas
Published/Copyright: November 12, 2013

Abstract

Objective: Twin studies offer opportunities to investigate mechanisms underlying sex-associated differences in perinatal outcomes. The objective of the study was to investigate sex-related differences in perinatal complications.

Study design: A cohort of 16,045 twin pregnancies – 32,090 twins – was explored for obstetric complications, perinatal and infant mortality, and neonatal morbidities.

Results: Twin pregnancies with a female fetus had an increased risk for preeclampsia, but otherwise there were no pregnancy complications associated with fetal sex. After birth, female-female twins had lower early neonatal and infant mortality, and lower risk for respiratory morbidities than male-male twins at all gestational ages. In unlike-sexed twin pairs, very preterm males had higher respiratory morbidity than females and, females were at higher risk for being growth restricted.

Conclusion: Male-male twins have higher respiratory morbidity and neonatal mortality than female-female twins. In unliked-sexed twin pairs, the males seem to be protected by having a female co-twin.


Corresponding author: Emma Elsmén Steen, MD, PhD, Department of Pediatrics, University Hospital, SE-221 85 Lund, Sweden, Tel.: +46-08-51770000, E-mail:

Acknowledgments

The study was supported by grants from the Swedish Medical Research Council (Grant 0037), Lund University Hospital Funds and Uppsala University.

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The authors stated that there are no conflicts of interest regarding the publication of this article.

Received: 2013-6-19
Accepted: 2013-10-8
Published Online: 2013-11-12
Published in Print: 2014-3-1

©2014 by Walter de Gruyter Berlin Boston

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