Reappraisal of twinning: epidemiology and outcome in the early neonatal period |
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Authors: | Priyanka Gupta Mohammad Moonis Akbar Faridi Neerja Goel Zeashan Zaidi |
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Affiliation: | 1.Division of Neonatology, Department of Paediatrics, India;2.Obstetrics and Gynaecology, University College of Medical Sciences, Delhi, India;3.Department of Biostatistics, Era’s Lucknow Medical College, Uttar Pradesh, India |
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Abstract: | INTRODUCTIONThe present study aimed to determine the epidemiology, maternal complications and adverse neonatal outcomes associated with twin births at a tertiary care hospital in India.METHODSA prospective observational study was conducted on all successively born twin pairs (≥ 23 weeks of gestation) and their mothers from January to September 2005. Main outcome measures included maternal medical/obstetric complications, labour characteristics and the morbidities/mortality observed during the early neonatal period.RESULTSThe twinning rate was 1 in 54 deliveries. Around 10% of mothers had a predisposition for twinning in the form of familial tendency or consumption of clomiphene. Anaemia (85%) was the most common maternal complication, followed by gestational hypertension (17%). Nearly one-third of births were delivered via Caesarean section. Prematurity (61%) was the most common neonatal complication followed by early-onset neonatal sepsis (21%). The risk of early neonatal death was 27%. Shorter gestation and low birth weight were significantly associated with adverse neonatal outcome (p < 0.05). Factors such as chorionicity, mode of delivery, birth order, inter-twin delivery time interval, gender and intra-pair birth weight discordance did not affect neonatal morbidity or mortality (p ≥ 0.05).CONCLUSIONThe rates of maternal complications and early neonatal morbidities/mortality were quite high in twin gestations. Except for the prematurity and low birth weight, none of the other factors, including inter-twin delivery time interval of more than 15 mins, were found to affect neonatal outcome. |
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Keywords: | inter-twin delivery time interval morbidities mortality twins |
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