Preterm twins may predict preterm singletons

Women who deliver preterm twins may have a fivefold higher risk of preterm delivery in a subsequent singleton pregnancy than women who deliver full-term twins, according to study findings published in the September issue of the American Journal of Obstetrics and Gynecology.

Francesca L. Facco, MD, of the Feinberg School of Medicine at Northwestern University in Chicago, and colleagues studied 167 mothers of twins-including 99 whose twin delivery was preterm-who subsequently had a singleton pregnancy.

The researchers found that mothers of preterm twins were significantly more likely than mothers of full-term twins to have a preterm singleton pregnancy (13.1% vs. 2.9%).

“These data can help physicians and patients better quantify the risk of preterm delivery and aid in the counseling of patients with a history of preterm birth of twins,” the authors conclude. “Meis et al. studied women with a previous preterm delivery of a singleton pregnancy and demonstrated that weekly injections of 17 alpha-hydroxyprogesterone caproate resulted in a significant reduction in the rate of recurrent preterm delivery in a subsequent singleton gestation. It remains uncertain whether women with a previous preterm delivery of twins, currently pregnant with a singleton fetus, would benefit from treatment with progesterone.”

Facco FL, Nash K, Grobman WA, et al. Are women who have had a preterm twin delivery at greater risk of preterm birth in a subsequent singleton pregnancy? Am J Obstet Gynecol. 2007;197:253.e1-.e3.