Twin pregnancies: an 11-year review

Area of Science:

• Obstetrics and Gynecology
• Perinatology
• Neonatology

Background:

• Twin pregnancies represent a significant obstetric challenge, with higher risks compared to singleton births.
• Understanding factors influencing twin outcomes is crucial for improving neonatal care and reducing mortality.
• Previous research indicates potential links between gestational age, birthweight, sex, and twin survival rates.

Purpose of the Study:

• To investigate the relationships between infant sex, gestational age, birthweight, and mortality in twin pregnancies.
• To evaluate the impact of delivery mode and interval on fetal outcomes in twins.
• To identify key factors contributing to the high mortality rate observed in twin births.

Main Methods:

• Retrospective analysis of 228 twin pregnancies from 16752 deliveries at the University Women's Clinic in Heidelberg (1971-1981).
• Utilized chi-squared (χ²) curves to assess the strength and course of relationships between various parameters.
• Fetal outcome evaluation focused on birthweight and delivery interval.

Main Results:

• Twin mortality rate was 8.3%, significantly influenced by birthweight and infant sex.
• No correlation was found between the mode of delivery and twin mortality.
• All twins were classified as 'small-for-date' (below the 25th percentile of singleton birthweights).
• Weight gain deceleration was noted after 35 weeks of gestation, exacerbating prematurity-related risks.

Conclusions:

• Immaturity and twin-specific factors are primary contributors to elevated twin mortality.
• Birthweight and infant sex are critical determinants of twin survival.
• Further research into optimizing care for 'small-for-date' twins and addressing gestational age-related risks is warranted.