Multifetal pregnancies: preterm admissions and outcomes
Tim Badgery-Parker1, Antonia W Shand, Jane B Ford
1Clinical and Population Perinatal Health Research, Kolling Institute of Medical Research, University of Sydney, University of Sydney at Royal North Shore Hospital, St Leonards, NSW 2065, Australia. tbadg@doh.health.nsw.gov.au
Summary
Antenatal hospital admission is common for multifetal pregnancies, often leading to preterm birth. This study provides key data on admission rates and outcomes for twin and higher-order multiple gestations.
Area of Science:
- Maternal-Fetal Medicine
- Obstetrics
- Perinatology
Background:
- Multifetal pregnancies, including twins and higher-order multiples, present unique challenges in prenatal care.
- Understanding patterns of antenatal hospital admission is crucial for managing these high-risk pregnancies.
Purpose of the Study:
- To determine the incidence of antenatal hospital admissions in women with twin or higher-order multifetal pregnancies.
- To analyze the outcomes of these admissions, including discharge without delivery, transfer to higher care, and delivery (spontaneous or elective).
Main Methods:
- A cohort study utilizing linked birth and hospital data from 2001-2008.
- Inclusion criteria: women with twin or higher-order multiple births (≥24 weeks gestation) admitted between weeks 20-36 of pregnancy.
Main Results:
- Hospital admission occurred in 63.4% of twin pregnancies and 99.5% of triplet/quadruplet pregnancies.
- Admission reasons included preterm labor (34.2%). Outcomes varied: 46.3% discharged undelivered, 10.7% transferred, 21.1% spontaneous delivery, 21.8% elective delivery.
- A total of 10,985 admissions were recorded for 10,779 twin and 197 higher-order pregnancies.
Conclusions:
- Antenatal hospitalization is frequent for women carrying multifetal pregnancies.
- A significant proportion of these admissions result in preterm birth, highlighting the need for specialized care and resource allocation.
- This study establishes a baseline for hospital utilization in multifetal pregnancy populations.
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