Associated factors with neonatal near miss in twin pregnancies in a public referral maternity unit in Brazil

Abstract

Objective: The aim was to analyze the factors associated with neonatal near miss (NNM) in twin pregnancies in a public referral maternity unit in Brazil. Material and Methods: This retrospective, cross-sectional study included 697 twin newborns. Cases of fetal and neonatal deaths were excluded. Neonates were divided into those meeting NNM criteria (5 min Apgar score <7, birth weight <1,500 g, gestational age at delivery <32 weeks, use of mechanical ventilation or congenital malformation, transfer before 28 days of life) and those who did not. In the bivariate analysis, the chi-square and Fisher’s exact tests were used. Variables with a p-value ≤0.20 were subjected to the multiple analyses, which followed the Poisson regression model. Results: The cohort consisted of 130 (18.7%) neonates meeting NNM criteria and 567 (81.3%) with no NNM criteria after multiple analyses, the following variables were associated with NNM: no previous pregnancy, prevalence ratio (PR): 1.38 [95% confidence interval (CI), 1.03-1.85]; >3 previous pregnancies, PR: 1.93 (95% CI, 1.38-2.69); premature rupture of membranes, PR: 1.50 (95% CI, 1.70-2.12); intrauterine growth restriction, PR: 2.28 (95% CI, 1.53-3.33); premature labor, PR: 1.63 (95% CI, 1.13-2.35); resuscitation in the delivery room, PR: 1.80 (95% CI, 1.24-2.62); and transfusion of blood products, PR: 4.44 (95% CI, 3.14-6.28). Conclusion: The study findings indicate that having had 0 or >3 previous pregnancies, premature rupture of the membranes, intrauterine growth restriction, resuscitation in the delivery room, premature labor, and transfusion of blood products were associated with NNM in twin pregnancies.

Factors influencing neonatal outcomes in twin pregnancies undergoing cesarean section: a cross-sectional study

“…Previous studies found a relationship between advanced maternal age and neonatal near-miss in nulliparous and multiparous women 6 . In addition, it was stated that neonatal near-miss risk in twins was associated with parity, an early gestational week, and intrauterine growth restriction 18 . Although maternal age affects the prevalence of twins, it does not appear to affect twin pregnancy outcomes; furthermore, the preterm birth risk was higher among younger mothers 19 .…”

In twin pregnancies, zinc and iron levels decreased compared to single pregnancies, while copper levels increased minimally. It is interesting.

“…The rate of twin pregnancies in all pregnancies is approximately 1-2% 1 . In multiple pregnancies, an increase has been seen in recent years, and the reason for this is the development of reproductive techniques and advanced maternal age 2 . The increase in the frequency of multiple pregnancies is accompanied by negativities related to maternal and fetus health.…”