Perinatal morbidity and early neonatal mortality in twin pregnancies

Objective: To evaluate vaginal birth safety by comparing the results of cesarean birth in twin pregnancies with the first twin in vertex presentation. Material and methods: A retrospective cohort study of vertex-presenting twin pregnancies between 32 weeks 0 days and 38 weeks 6 days of gestation was conducted at our hospital from January 2013 to December 2014. The study population was divided according to the mode of birth. The primary outcome was early neonatal mortality, and secondary outcomes related to maternal and perinatal clinical characteristics were analysed between the groups. Results: Of 45,166 births, 1.92% (n = 869) were twin pregnancies. Of the 295 pregnancies meeting the study criteria, 30.16% (n = 89) were in the vaginal birth group, while the remaining 69.84% (n = 206) were in the cesarean birth group. In the vaginal birth group, all the first twins were delivered via vaginal birth, while among the second twins, 82.03% (n = 73) were delivered via vaginal birth, and the remaining 17.97% (n = 16) were delivered via cesarean birth. In the vaginal birth group, the early neonatal mortality rate was 22.4‰ (n = 2), and it was 9.7‰ (n = 2) in the cesarean birth group. All of the deaths occurred in pregnancies under 37 weeks of gestation. Conclusion: The neonatal outcomes between the vaginal birth and cesarean birth groups were similar in term pregnancies with the first in twin vertex presentation, whereas adverse neonatal outcomes were increased in the vaginal birth group in preterm second twin pregnancies.

Download Full-text

Perinatal outcomes in Finnish twins: a retrospective study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-019-2670-3 ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Annu-Riikka Susanna Rissanen ◽

Riina Maria Jernman ◽

Mika Gissler ◽

Irmeli Katriina Nupponen ◽

Mika Erkki Nuutila

Keyword(s):

Regression Analysis ◽

Neonatal Mortality ◽

Perinatal Mortality ◽

Neonatal Intensive Care ◽

Perinatal Outcomes ◽

Study Data ◽

Early Neonatal Mortality ◽

Medical Birth Register ◽

Binomial Regression ◽

Twin Pregnancies

Abstract Background To establish the changes in perinatal morbidity and mortality in twin pregnancies in Finland, a retrospective register research was conducted. Our extensive data from a 28-year study period provide important information on the outcome of twin pregnancies in Finland that has previously not been reported to this extent. Methods All 23,498 twin pregnancies with 46,996 children born in Finland during 1987–2014 were included in the study. Data were gathered from the Medical Birth Register and the Hospital Discharge Register (Finnish Institute for Health and Welfare, Finland) regarding perinatal mortality (PNM) and morbidity. For statistical analysis, binomial regression analysis and crosstabs were performed. The results are expressed in means, percentages and ranges with comparison to singletons when appropriate. Odds ratios from binomial regression analysis are reported. A p-value <0.05 was considered statistically significant. Results There were 46,363 liveborn and 633 stillborn twins in Finland during 1987–2014. Perinatal mortality decreased markedly, from 45.1 to 6.5 per 1000 for twin A and from 54.1 to 11.9 per 1000 for twin B during the study period. Yet, the PNM difference between twin A and B remained. Early neonatal mortality did not differ between twins, but has decreased in both. Asphyxia, respiratory distress syndrome, need for antibiotics and Neonatal Intensive Care Unit (NICU) stay were markedly more common in twin B. Conclusions In Finland, PNM and early neonatal mortality in twins decreased significantly during 1987–2014 and are nowadays very low. However, twin B still faces more complications. The outline provided may be used to further improve the monitoring and thus perinatal outcome of twins, especially twin B.

Download Full-text

Incidence and risk factors for early neonatal mortality in newborns with severe perinatal morbidity in Uganda

International Journal of Gynecology & Obstetrics ◽

10.1016/j.ijgo.2014.05.017 ◽

2014 ◽

Vol 127 (2) ◽

pp. 201-205 ◽

Cited By ~ 7

Author(s):

Moses Musooko ◽

Othman Kakaire ◽

Annettee Nakimuli ◽

Sarah Nakubulwa ◽

Jolly Nankunda ◽

...

Keyword(s):

Risk Factors ◽

Neonatal Mortality ◽

Perinatal Morbidity ◽

Early Neonatal Mortality

Download Full-text

Socio-Economic Inequalities in Early Neonatal Mortality in India

Artha Vijnana Journal of The Gokhale Institute of Politics and Economics ◽

10.21648/arthavij/2017/v59/i1/164436 ◽

2017 ◽

Vol 59 (1) ◽

pp. 77

Author(s):

Binod Jena ◽

Ananta Basudev Sahu

Keyword(s):

Neonatal Mortality ◽

Early Neonatal Mortality ◽

Economic Inequalities

Download Full-text

Early neonatal mortality, asphyxia related deaths, and timing of low risk births in Hesse, Germany, 1990-8: observational study

BMJ ◽

10.1136/bmj.321.7256.274 ◽

2000 ◽

Vol 321 (7256) ◽

pp. 274-275 ◽

Cited By ~ 38

Author(s):

G. Heller

Keyword(s):

Observational Study ◽

Neonatal Mortality ◽

Low Risk ◽

Early Neonatal Mortality

Download Full-text

Incidence of Early Neonatal Mortality and Morbidity After Late-Preterm and Term Cesarean Delivery

PEDIATRICS ◽

10.1542/peds.2008-2407 ◽

2009 ◽

Vol 123 (6) ◽

pp. e1064-e1071 ◽

Cited By ~ 108

Author(s):

R. De Luca ◽

M. Boulvain ◽

O. Irion ◽

M. Berner ◽

R. E. Pfister

Keyword(s):

Cesarean Delivery ◽

Neonatal Mortality ◽

Late Preterm ◽

Mortality And Morbidity ◽

Early Neonatal Mortality

Download Full-text

Editorial–Special Issue

Twin Research and Human Genetics ◽

10.1017/thg.2016.30 ◽

2016 ◽

Vol 19 (3) ◽

pp. 167-167 ◽

Cited By ~ 2

Author(s):

Mark P. Umstad ◽

Ricardo Palma-Dias ◽

Asma Khalil

Keyword(s):

Well Being ◽

Morbidity And Mortality ◽

Perinatal Morbidity ◽

Special Issue ◽

Monochorionic Twin ◽

Editorial Special Issue ◽

Twin Pregnancies

Monochorionic twin pregnancies are subject to unique complications that can threaten the life and well-being of both fetuses, resulting in a disproportionate increase in perinatal morbidity and mortality.

Download Full-text

Early neonatal mortality and risk factors: a case-control study in Paraná State

Revista Brasileira de Enfermagem ◽

10.1590/0034-7167-2016-0586 ◽

2018 ◽

Vol 71 (5) ◽

pp. 2527-2534 ◽

Cited By ~ 6

Author(s):

Michelle Thais Migoto ◽

Rafael Pallisser de Oliveira ◽

Ana Maria Rigo Silva ◽

Márcia Helena de Souza Freire

Keyword(s):

Risk Factors ◽

Neonatal Mortality ◽

Neonatal Death ◽

Secondary Data ◽

Case Control ◽

Management Tool ◽

Early Neonatal Death ◽

Maternal Risk ◽

Early Neonatal Mortality ◽

Technological Management

ABSTRACT Objective: to analyze the Early Neonatal Mortality risk factors according to the risk stratification criteria of the Guideline of the Rede Mãe Paranaense Program. Method: a case-control epidemiological study with secondary data from the Mortality and Live Birth Information System in 2014. The crude analysis was performed by the Odds Ratio association measure, followed by the adjusted analysis, considering risk factors as independent variables, and early neonatal death as dependent variable. Results: were considered as maternal risk factors: absence of partner and miscarriages; neonatal: male, low birth weight, prematurity, Apgar less than seven in the fifth minute, presence of congenital anomaly; and care: up to six prenatal appointments. Conclusion: an innovative study of risk factors for early neonatal death from the Guideline's perspective, a technological management tool for maternal and child health, in search of its qualification and greater sensitivity.

Download Full-text