Maternal and perinatal outcomes and factors associated with twin pregnancies among preterm births: Evidence from the Brazilian Multicenter Study on Preterm Birth (<scp>EMIP</scp>)

Santana, Danielly S.; Cecatti, José Guilherme; Surita, Fernanda Garanhani; Tedesco, Ricardo Porto; Passini, Renato; Souza, Renato T.; Lajos, Giuliane J.; Dias, Tábata Z.; Nomura, Marcelo Luís; Rehder, Patrícia Moretti; Sousa, Maria Helena de

doi:10.1002/ijgo.13107

Cited by 7 publications

(9 citation statements)

References 34 publications

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“…The incidence of preterm birth in twin pregnancies found in this research was comparable to prior studies (13,15,17,18). Drawing from the work of Santana et al, our study echoes the nding that the primary culprit behind preterm births in twin pregnancies is the spontaneous onset of preterm labor, accounting for 74.7% of the preterm twin births recorded here (19). Other studies, like those by Oger et al and Feng et al, corroborate our observations that neonates from monochorionic twin pregnancies face heightened morbidities.…”

Section: Discussionsupporting

confidence: 89%

“…The past decade has seen a rise in the prevalence of twin deliveries. The recorded rate of 1.99% per 100 live births in this study is higher than gures reported in previous Thai studies conducted between 2004-2009 (13, 14) but align well with studies from the decade of the current study (15,(18)(19)(20)(21). The incidence of preterm birth in twin pregnancies found in this research was comparable to prior studies (13,15,17,18).…”

Section: Discussionsupporting

confidence: 87%

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Epidemiology and factors associated with preterm births in multiple pregnancy: A retrospective cohort study

Seetho,

Kongwattanakul,

Saksiriwuttho

et al. 2023

Preprint

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Objective Multiple pregnancies carry an increased risk of maternal and perinatal complications, notably prematurity. There is a limited number of studies evaluating the risk factors for preterm births in multiple pregnancies within the Thai population. This study aims to ascertain maternal and perinatal outcomes and identify factors linked to preterm births in multiple pregnancies. Methods This study was carried out at the Khon Kaen University Faculty of Medicine Department of Obstetrics and Gynecology in Thailand. We included women with multiple pregnancies who delivered at a gestational age of more than 20 weeks between January 1, 2012, and December 31, 2021. Medical records were meticulously reviewed. We excluded patients with incomplete data or those for whom data were missing. Results Out of 21,400 pregnancies, 427 were multiple pregnancies, constituting approximately 1.99%. Over the ten-year period, 269 multiple pregnancies (65.1%) resulted in preterm births. Of these, 173 (64.3%) were monochorionic twins, and 96 (35.7%) were dichorionic twins. Monochorionic twins had a notably higher rate of preterm delivery (AOR, 2.06; 95%CI 1.29–3.30). Vaginal delivery was observed in 7.9% of the cases, while cesarean sections were performed for both twins in 91.5% of cases. In 0.5% of the cases, only the second twin was delivered by cesarean section. With regard to neonatal outcomes, 160 infants (19.4%) weighed less than 1500 grams at birth, and there were 78 perinatal deaths (9.4%). Birth asphyxia was noted in 97 cases (20.2%) among monochorionic twins and in 28 cases (8.1%) for dichorionic twins. Conclusion The prevalence of multiple pregnancies was 1.99%, with 65.1% resulting in preterm births. Neonatal complications were notably more frequent in monochorionic twins. The monochorionic placenta and antepartum complications emerged as significant risk factors for preterm birth.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 87%

Epidemiology and factors associated with preterm births in multiple pregnancy: A retrospective cohort study

Seetho,

Kongwattanakul,

Saksiriwuttho

et al. 2023

Preprint

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“…The twin birth rate in China has dramatically risen over the last decade, from 16.4‰ in 2007 to 21.7‰ in 2014, owing to the widespread use of assisted reproductive technology and increased maternal age 1 . Twin pregnancies are associated with increased perinatal morbidity and mortality, given that they are at increased risk for spontaneous preterm birth (sPTB), about half of twin pregnancies are delivered preterm, 2,3 and it is unclear whether any intervention reduces this risk 4–8 …”

Section: Introductionmentioning

confidence: 99%

“…are delivered preterm, 2,3 and it is unclear whether any intervention reduces this risk. [4][5][6][7][8] Cervical cerclage represents one of the best-known surgical interventions to prevent sPTB in obstetrics.…”

mentioning

confidence: 99%

Pregnancy outcomes and factors affecting the clinical effects of emergency cerclage in twin pregnancies with cervical dilation and prolapsed membranes

Zeng

Pei

et al. 2021

Intl J Gynecology & Obste

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Objective To determine the effect of mid‐trimester emergency cerclage in women with twin pregnancies with cervical dilation and prolapsed membranes, and to identify risk factors predicting spontaneous preterm birth (sPTB) before 28 weeks, after cerclage. Methods Retrospective analysis of twin gestations with cervical dilation and prolapsed membranes treated with emergency cerclage or expectant management (2015–2020). The primary outcomes were the rate of sPTB before 28 weeks and the gestational latency. Multiple logistic regression analysis was used to determine the factors associated with sPTB before 28 weeks, after cerclage. Results Ninety‐seven women were included, cerclage (n = 58) or no cerclage (n = 39). Cerclage placement was associated with significantly lower incidence of sPTB before 28 weeks of pregnancy (34.5% vs 82.1%) and prolongation of the gestational latency (46.71 ± 27.52 vs 10.95 ± 11.71 days). Positive cervical culture (odds ratio [OR] 10.69, 95% confidence interval [CI] 1.82–62.95), pregnancy duration at diagnosis less than 22 weeks (OR 9.42; 95% CI 1.69–52.69) and cervical dilation at least 4 cm (OR 7.92; 95% CI 1.40–44.71) were found to be independent risk factors for sPTB before 28 weeks, after cerclage. Conclusion Emergency cerclage in women with twin pregnancies with cervical dilation and prolapsed membranes was associated with an overall 40% decrease in sPTB before 28 weeks and a prolongation of latency by 5 weeks. The strongest predictor of sPTB before 28 weeks after cerclage was a positive cervical culture.

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“…Due to inherent biological factors, a twin pregnancy is associated with various adverse perinatal outcomes and maternal obstetrics complications [ 11 ]. Preterm birth, low birth weight, twin to twin transfusion syndrome, perinatal deaths, and admission to neonatal intensive care unit (NICU) are among many adverse perinatal outcomes associated with twin pregnancy [ 12 , 13 ]. For example, the rate of perinatal mortality among twin pregnancies could be up to six times higher compared to singleton pregnancies [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Perinatal outcome of twin pregnancies among mothers who gave birth in Adama Hospital Medical College, Central Ethiopia

et al. 2022

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Introduction Twin pregnancy carries a high risk of pregnancy-related complications including adverse perinatal outcomes. Although evidence from international studies indicated an increased risk of adverse perinatal outcomes in twin pregnancies, little is known about the adverse perinatal outcomes in twin pregnancies and associated factors in Ethiopia. The purpose of this study was, therefore, to estimate the incidence of twin pregnancies and related-adverse perinatal outcomes and identify factors associated with adverse perinatal outcomes in twin pregnancies in Ethiopia. Methods A hospital-based retrospective cross-sectional study was conducted among 322 mothers who gave twin birth at Adama Hospital Medical College between 08 July 2015 and 07 June 2017. In this study, the adverse perinatal outcome was defined as the presence of any of the following main conditions: low birth weight, preterm birth, stillbirth, low Apgar Scores, mal-presentation, Admission to neonatal Intensive Care Unit (NICU), and early neonatal deaths. The data were analyzed using SPSS version 20.0. Multivariable logistic regression was conducted to identify factors associated with adverse perinatal outcome at 95% CI or P-value of less than 0.05. Result Of 10,850 births recorded in the hospital, 354 births were twins and 322 of these paired records had complete perinatal information. One hundred ninety-nine (61.8%) of the 322 paired birth records had at least one adverse perinatal outcome on one or both twins. Low birth weight was the most common perinatal outcome followed by preterm birth. After adjusting for confounding factors, younger maternal age (AOR = 4.1, 95% CI; 1.3, 12.5) and not having ultrasound scan during antenatal care (AOR = 2.0, 95% CI: 1.2, 3.1) were significantly associated with adverse perinatal outcomes. Conclusion The incidence of adverse perinatal outcome in twin pregnancies was high, that is, in 61.8% of twin births, there was at least one adverse perinatal outcome on one or both twins. Moreover, younger maternal age at birth and not having an ultrasound scan during antenatal care were found to be strong predictors for the observed high incidence of adverse perinatal outcomes.

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Maternal and perinatal outcomes and factors associated with twin pregnancies among preterm births: Evidence from the Brazilian Multicenter Study on Preterm Birth (EMIP)

Cited by 7 publications

References 34 publications

Epidemiology and factors associated with preterm births in multiple pregnancy: A retrospective cohort study

Epidemiology and factors associated with preterm births in multiple pregnancy: A retrospective cohort study

Pregnancy outcomes and factors affecting the clinical effects of emergency cerclage in twin pregnancies with cervical dilation and prolapsed membranes

Perinatal outcome of twin pregnancies among mothers who gave birth in Adama Hospital Medical College, Central Ethiopia

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