Obstet Gynecol Sci.  2019 Mar;62(2):93-102. 10.5468/ogs.2019.62.2.93.

Perinatal outcome of twin pregnancies according to maternal age

  • 1Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. drmaxmix.choi@samsung.com
  • 2Department of Obstetrics and Gynecology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.


To investigate the perinatal outcomes of twin pregnancies according to maternal age.
This is a retrospective cohort study of twin pregnancies delivered ≥24 weeks' gestation at a tertiary academic hospital from 1995 to 2016. Subjects were categorized into 5 groups according to maternal age: < 25, 25-29, 30-34, 35-39, and ≥40 years. Maternal and neonatal outcomes of each maternal age group were analyzed using the Jonckheere-Terpstra test and the linear-by-linear association test.
A total of 1,936 twin pregnant women were included, of which 47 (2.4%), 470 (24.3%), 948 (49.0%), 417 (21.5%), and 54 (2.7%) women were aged < 25, 25-29, 30-34, 35-39, and ≥40 years, respectively. Higher maternal age was significantly associated with a higher rate of dichorionic twins and a higher risk of gestational diabetes and placenta previa. However, rates of preterm labor, preterm premature rupture of membranes, cervical incompetence, preterm delivery, preeclampsia, placenta abruption, and cesarean section were not associated with maternal age. Birth weight increased and the rate of admission to the neonatal intensive care unit (NICU) decreased with older maternal age, but other neonatal outcomes did not change with age. Maternal age was significantly associated with a lower rate of NICU admission after controlling for potential confounding factors in multivariable analysis.
Advanced maternal age in twin pregnancies was associated with increased risk of gestational diabetes, placenta previa, and higher birth weight but a lower rate of NICU admission. However, other outcomes were not significantly associated with maternal age.


Maternal age; Twin pregnancy, Perinatal care

MeSH Terms

Birth Weight
Cesarean Section
Cohort Studies
Diabetes, Gestational
Infant, Newborn
Intensive Care, Neonatal
Maternal Age*
Obstetric Labor, Premature
Placenta Previa
Pregnancy, Twin*
Pregnant Women
Retrospective Studies


  • Fig. 1 Numbers and rates of twin birth.

  • Fig. 2 Numbers and rates of twin births according to the maternal age.

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