Perinatal mortality rate in multiple pregnancies: a 20-year retrospective study from a tertiary obstetric unit in Hong Kong

Abstract

Introduction: Multiple pregnancies have become more common, but their perinatal mortality rate remains higher than the rate among singleton pregnancies. This retrospective study investigated the prevalence and causes of perinatal mortality among multiple pregnancies in Hong Kong.Methods: All multiple pregnancies in a university tertiary obstetric unit between 2000 and 2019 were reviewed, and the medical records of cases complicated by stillbirth and neonatal death were identified. The causes of perinatal mortality were determined based on clinical assessment and laboratory results, then compared between the first (2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009) and second (2010-2019) decades. Results:The prevalence of multiple pregnancies increased from 1.41% in the first decade to 1.91% in the second decade (P<0.001). Compared with the first decade, the second decade had a lower stillbirth rate (14.72 vs 7.68 [both per 1000 births]; P=0.026), late neonatal death rate (4.78 vs 1.16 [both per 1000 livebirths]; P=0.030), and total mortality rate (25.32 vs 13.82 [both per 1000 births]; P=0.006). The decline in stillbirth rate was related to improvements in antenatal care and treatment. The decline in the

Neonatal mortality in singleton pregnancies: a 20-year retrospective study from a tertiary perinatal unit in Hong Kong

“…3 The rate of perinatal mortality in multiple pregnancies also decreased from 5.52/1000 to 4.59/1000 during the same period. 4 These improvements in mortality rates have mainly occurred because of advances in the prenatal diagnosis and management of fetal malformations and genetic diseases, as well as improvements in the antenatal management of multiple pregnancies. The present study investigated the trends of NNDs among singleton pregnancies in the largest tertiary perinatal centre in Hong Kong, as well as changes in the characteristics and aetiologies of NND over the past two decades, with the goal of improving perinatal care in Hong Kong.…”

Neonatal outcome of infants with umbilical cord arterial pH less than 7

“…Significant birth asphyxia is one of the major causes of stillbirths, neonatal death, infant death and adverse long‐term outcomes such as cerebral palsy and developmental delay 1–4 . Acute intrapartum hypoxic events such as placental abruption, uterine rupture, cord prolapse, and shoulder dystocia cause anaerobic metabolism, which can lead to rapid deterioration of umbilical cord arterial pH within a short period 5–8 .…”

“…Significant birth asphyxia is one of the major causes of stillbirths, neonatal death, infant death and adverse long‐term outcomes such as cerebral palsy and developmental delay. 1 , 2 , 3 , 4 Acute intrapartum hypoxic events such as placental abruption, uterine rupture, cord prolapse, and shoulder dystocia cause anaerobic metabolism, which can lead to rapid deterioration of umbilical cord arterial pH within a short period. 5 , 6 , 7 , 8 The effects of fetal acidosis have been associated with hypoxic ischemic encephalopathy (HIE), the need for cardiopulmonary resuscitation, intubation, seizures, cerebral palsy, developmental delay, and mortality.…”