Twin pregnancy in women above the age of 45 years: Maternal and neonatal outcomes

Tomer Avnon, Alon Haham, Ariel Many

Research output: Contribution to journalArticlepeer-review


Childbearing age continues to rise and, with the increasing implementation of assisted reproductive technology (ART), the number of multiple pregnancies has also risen. This is a retrospective cohort study on maternal and neonatal outcomes of the twin pregnancies of 57 women aged ≥45 years compared to 114 younger women who gave birth in our institution between January 2011 and August 2015. Data were extracted from the real-time computerized database. The rates of hypertensive complications and pre-eclampsia (PE) were much higher in the study group compared to the controls (24/57 vs. 19/114, P=0.000 and 15/57 vs. 13/114, P=0.013, respectively). The respective incidence of very low birth weight (VLBW) was also significantly higher (14/114 vs. 12/228, P=0.021). Infants in the study group required four times more intubation and had a higher admission rate to the neonatal intensive care unit (NICU) compared to control infants (14/114 vs. 6/228 P=0.000 and 42/114 vs. 57/228, P=0.023, respectively). We conclude that women older than 45 years with twin pregnancies have higher maternal and perinatal complications with worse outcomes in comparison with younger women. When pregnancy is attempted via ART, embryo transfer of only one embryo should be considered in this age group.

Original languageEnglish
Pages (from-to)787-791
Number of pages5
JournalJournal of Perinatal Medicine
Issue number7
StatePublished - 26 Oct 2017
Externally publishedYes


  • Assisted reproductive technology
  • neonatal intensive care unit
  • pre-eclampsia
  • pre-term delivery
  • twin pregnancy
  • very advanced maternal age
  • very low birth weight


Dive into the research topics of 'Twin pregnancy in women above the age of 45 years: Maternal and neonatal outcomes'. Together they form a unique fingerprint.

Cite this