Maternal complications in twin pregnancies in Finland during 1987–2014: a retrospective study

Abstract

Background To investigate the trends and changes in the incidence and overall outcome of twin pregnancies in Finland, a retrospective study was conducted with emphasis on maternal complications, covering a 28-year study period. Methods All 23,498 twin pregnancies with 46,363 live born and 633 stillborn children in Finland during 1987–2014 were included in the study. Data were collected from the national Medical Birth Register and the Care Register on Hospital Care (Finnish Institute for Health and Welfare, Finland) regarding the parturients’ characteristics and incidences of several pregnancy and childbirth complications. The incidences of twin pregnancies and maternal complications during pregnancy and childbirth are the main outcome measures of the study. The results are expressed in percentages, means, medians, ranges and standard deviations (SD), when appropriate. Results Twins comprised 1.4% of all births in Finland in 1987–2014. Parturients’ mean age has remained stable, but the share of over 35 year-old parturients is increasing. The incidences of pre-eclampsia, intrahepatic cholestasis of pregnancy, gestational diabetes and postpartum haemorrhage have risen during the study period. Almost half (44.9%) of twins were born preterm, almost half via Caesarean section (47.1%), and 27.7% of twin labours were induced. Conclusions Several pregnancy complications increased during the study period. Advanced maternal age among twin parturients has risen, enhancing the risks for developing complications in a pregnancy already of a high-risk category, and predisposing to preterm delivery. National and international guidelines are necessary to improve the overall outcome of twin pregnancies.

Obstetric outcomes of twin pregnancies presenting with a complete hydatidiform mole and coexistent normal fetus: a systematic review and meta‐analysis

“…The prospective risk of IUFD at ≥34 weeks’ gestation is 0.17% for dichorionic twins 44,45 . There is no significant difference in the risk of stillbirth between dichorionic and monochorionic twins 43,45 . Our analysis indicates that twin pregnancies combining a CHM and a normal fetus both have a very high rate of preterm delivery and IUFD, with only a 50% overall live‐birth rate.…”

“…44,45 There is no significant difference in the risk of stillbirth between dichorionic and monochorionic twins. 43,45 Our analysis indicates that twin pregnancies combining a CHM and a normal fetus both have a very high rate of preterm delivery and IUFD, with only a 50% overall live-birth rate. Pre-eclampsia and chronic vaginal bleeding are probably both major contributors to these perinatal complications.…”

“…Independent of zygosity, twin pregnancies are also associated with higher risks preterm delivery 43,44 and around 45% of twins are born preterm. 43 The prospective risk of IUFD at ≥34 weeks' gestation is 0.17% for dichorionic twins. 44,45 There is no significant difference in the risk of stillbirth between dichorionic and monochorionic twins.…”

Micronutrients in Multiple Pregnancies—The Knowns and Unknowns: A Systematic Review

“…Moreover, higher levels of chorionic gonadotropin observed in multiple pregnancies predispose to hyperemesis gravidarum, which may be another cause of maternal malnutrition [ 16 , 17 ]. Furthermore, pregnancies with an initially increased risk of numerous complications, including fetal growth disorders, pre-eclampsia, gestational diabetes or preterm labor may also constitute a contributing factor [ 18 , 19 , 20 ]. Therefore, it seems that the supply of nutrients should be properly tailored to the increased needs of a woman to effectively combat all potentially modifiable risk factors.…”

Correction to: Maternal complications in twin pregnancies in Finland during 1987–2014: a retrospective study

“…Following publication of the original article [ 1 ], the authors identified some errors in Methods, Results and Discussion sections.…”