Medical care and perinatal health in twin pregnancies: Situation in 2010 and recent trends in France

Objective. - To compare medical care and health status of twins and singletons in 2010 and to describe the trends between 1995 and 2010 in metropolitan France. Populations and methods. - Data were derived from the national perinatal surveys from 1995 to 2010, on representative samples of births, and included 14,460 singletons and 440 twins in 2010. We compared prenatal care, childbirth and health status of children between twin and singleton pregnancies and between years. Results. - In 2010, mothers of twins had more intensive medical care than mothers of singletons. The preterm birth rate was higher (42.7% versus 6.3%). The medical care of twins has increased (for example 51% of women had 11 or more prenatal visits in 2010 versus 26% in 1995), often following the same trends as singletons. The proportion of non-spontaneous labors increased between 1998 and 2003. The cesarean section rate increased from 42.2% in 1995 to 54.8% in 2010 among twins, and from 15.2% to 19.9% among singletons. The preterm birth did not increase, but the proportion of twins born at 39 weeks of gestation or more declined significantly. Conclusion. - Medical care takes into account the high risks of twin pregnancies. Twins are still a medical cause for concern because of their continued increase. (C) 2014 Published by Elsevier Masson SAS.