Periviable multiple gestations: Are neonatal complications different than singletons born at the same gestational age?

Objectives: To evaluate maternal and neonatal complications and pregnancy outcomes of twin pregnancies. Methods: The cross sectional study was conducted using retrospective data on the twin pregnancies with more than 28 weeks of gestational age. The study used data over a period of five years, from March 10, 2010 to March 9, 2015 in the Department of Obstetrics and Gynecology, GMC Teaching Hospital Pokhara. Results: Of the 50 twin pregnancies, the most common maternal complication was preterm delivery (40%). Other maternal complications were anemia (36%), pregnancy induced hypertension (14%), premature rupture of membranes (14%), postpartum hemorrhage (12%) and antepartum hemorrhage (6%). Median gestational age at delivery was 37 weeks. Most common route of delivery was cesarean section (66%). Most common neonatal complication was low birth weight (48%) births first twin and second twin 56%. Conclusion: Twin pregnancy has high maternal and neonatal complications, especially preterm delivery that increases the risk of significant neonatal morbidity and mortality.

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Increased risk of neonatal complications or death among neonates born small for gestational age to mothers with gestational diabetes

Diabetes Research and Clinical Practice ◽

10.1016/j.diabres.2019.107971 ◽

2020 ◽

Vol 159 ◽

pp. 107971

Author(s):

Beatriz Barquiel ◽

Lucrecia Herranz ◽

Nuria Martínez-Sánchez ◽

Cristina Montes ◽

Natalia Hillman ◽

...

Keyword(s):

Gestational Diabetes ◽

Gestational Age ◽

Small For Gestational Age ◽

Neonatal Complications ◽

Increased Risk

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291: Induction of labor: Maternal and neonatal complications by gestational age

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2007.10.306 ◽

2007 ◽

Vol 197 (6) ◽

pp. S91

Author(s):

Anjali Kaimal ◽

James Nicholson ◽

Yvonne Cheng ◽

Deirdre Lyell ◽

A. Eugene Washington ◽

...

Keyword(s):

Gestational Age ◽

Induction Of Labor ◽

Neonatal Complications

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Fetal prognosis in cesarean section

Romanian Medical Journal ◽

10.37897/rmj.2021.3.4 ◽

2021 ◽

Vol 68 (3) ◽

pp. 347-353

Author(s):

Maria Saba ◽

◽

Dimitrie Nanu ◽

Keyword(s):

Caesarean Section ◽

Cesarean Section ◽

Gestational Age ◽

Neonatal Complications ◽

Clinical Complications ◽

Determining Factors ◽

Mode Of Birth

When deciding on a caesarean section, perinatologists should consider the consequences for the newborn. Studies show that caesarean section modifies adaptation to extrauterine life and is associated with risks of neonatal complications. Other determining factors for the condition and future of the newborn (gestational age, the existence of labor before cesarean section, anesthesia etc.) are not to be neglected. This article reviews the elements of the neonatal respiratory adaptation physiology, which are essential to understanding the clinical complications attributed to the mode of birth, and proposes a reconsideration of neonatal morbimortality after cesarean section.

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SMALL-FOR-DATES NEONATES

PEDIATRICS ◽

10.1542/peds.38.6.1013 ◽

1966 ◽

Vol 38 (6) ◽

pp. 1013-1019

Author(s):

A. Frederick North

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Gestational Age ◽

Lower Incidence ◽

Clinical Status ◽

Low Birth Weight Infants ◽

Term Infants ◽

Neonatal Complications ◽

Antecedent Conditions ◽

Longterm Outcome

Records of 762 infants weighing less than 2,500 gm at birth and born after 37 to 44 weeks' gestation—small-for-dates neonates—were compared with records of infants with similar birth weight born after 28 to 32 weeks' gestation—pre-term infants—and with records of infants weighing 3,000 to 3,500 gm born after 37 to 44 weeks' gestation—"average" infants. Records were compared with regard to maternal and gestational features, perinatal survival, and neonatal complications. The group of small-for-dates neonates differed markedly from the pre-term infants in 15 of the 35 variables examined and from the "average" infants in 31 of the 35 variables examined. Small-for-dates infants showed a higher incidence of maternal toxemia and hypertension, a greater incidence of primiparous mothers, a lower incidence of gestational bleeding, a lower incidence of low-birth-weight siblings, fewer neonatal complications and deaths, and a lower incidence of hemolytic disease and pulmonary disease in the newborn period than did weight-matched pre-term controls. Gestational age, though subject to error in measurement, is as important a predictor of neonatal clinical status and outcome as is birth weight. Future studies of the antecedent conditions, neonatal course, and longterm outcome of low-birth-weight infants must consider both birth weight and gestational age.

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Factors affecting birthweight decline in recent Japan based on birth certificates

10.21203/rs.3.rs-44763/v2 ◽

2020 ◽

Author(s):

Noriko Kato ◽

Catherine Sauvaget ◽

Honami Yoshida ◽

Tetsuji Yokoyama ◽

Nobuo Yoshiike

Keyword(s):

Birth Order ◽

Gestational Age ◽

Low Birthweight ◽

Maternal Diet ◽

Linear Regression Analysis ◽

Birth Certificate ◽

Vital Statistics ◽

Birth Certificates ◽

Maternal Body Mass Index ◽

Multiple Gestations

Abstract Background: Birthweight has been declining consistently for >30 years in Japan. This rapid rise in low birthweight in infants is the worst among the Organization for Economic Co-operation and Development countries.Objective: To contribute to the literature and provide new information to clarify the risk factors associated with birthweight decline in Japan.Methods: We used population-based birth certificate data from vital statistics records with prior permission and retrieved 40,968,266 birth certificates of neonates born between 1980 and 2004 to analyze time trends using linear regression analysis for examining whether the decline in birthweight could be explained by obstetrical variables such as gestational age and multiple gestations.Results: From 1980 to 2004, we observed a decline in mean birthweight with a yearly effect of -8.07 g, which became steeper after 1985, persisted until 1999, and plateaued thereafter. After adjusting for gestational age, neonatal gender, birth order, multiple gestations, and fathers’ age, the yearly effect between 1980 and 2004 reduced to -5.13 g. Conclusion: Recent decreases in birthweight among Japanese neonates were not explained fully by trends in gestational age, neonatal gender, birth order, multiple gestations, and fathers’ age. Thus, additional factors such as pre-pregnancy maternal body mass index and maternal diet should be considered.

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Multi-fetal pregnancy reduction (MFPR) to twins or singleton – medical justification and ethical slippery slope

Journal of Perinatal Medicine ◽

10.1515/jpm-2016-0058 ◽

2017 ◽

Vol 45 (2) ◽

Cited By ~ 5

Author(s):

Arie Drugan ◽

Amir Weissman

Keyword(s):

Cesarean Section ◽

Gestational Age ◽

Pregnancy Loss ◽

Well Being ◽

High Order ◽

Slippery Slope ◽

Good Outcome ◽

Multiple Gestations ◽

Gestational Age At Delivery

AbstractMulti-fetal pregnancy reduction (MFPR) is an ethically acceptable procedure aimed to increase survival and well-being of the remaining fetuses from high-order multiple gestations. In most cases we offer the procedure to triplets or quadruplets and opt to preserve twins; lately, the option to maintain a single fetus was suggested. We examined the outcomes of 140 pregnancies that underwent MFPR in our center and were followed to delivery – 105 were reduced to twins and 35 to singletons. The rate of procedure-related pregnancy loss was identical (2.9%). Leaving only one fetus was associated with a higher gestational age at delivery (35.4±2.4 weeks vs. 37.7±2.1 weeks, P<0.0001), with heavier neonates (2222 g vs. 3017 g, P<0.0001) and with a reduction in the cesarean section (CS) rate (76% in twins vs. 51.4% in singletons, P=0.02). Six pregnancies reduced to twins (5.8%) ended before 32 weeks as compared to one pregnancy reduced to a singleton. We conclude that reduction of triplets to singletons is medically and ethically acceptable, after thorough counseling of patients. However, considering the pregnancy loss risk of MFPR and the relatively good outcome of twin gestations, reduction of twins to singletons is ethically acceptable only in extraordinary maternal or fetal conditions.

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