Perinatal Outcomes and Risk Factors for Preterm Birth in Twin Pregnancies in a Chinese Population: A Multi-center Retrospective Study

Abstract

Background: Twin pregnancies are associated with an increased risk of adverse maternal and neonatal outcomes, mainly owing to prematurity. Few studies have evaluated the risk factors for preterm birth (PTB) in Chinese population. The objective of this study is to present the short-term maternal-neonatal outcomes, investigating the potential risk factors associated with preterm birth in Chinese twin pregnancies.Methods: A multi-center retrospective study of women pregnant with twins ≥28 weeks of gestation was conducted. Maternal and neonatal outcomes were analyzed. Logistic regression was used to identify potential risk factors for PTB before 37, 34, and 32 weeks, respectively.Results: A total of 3,288 twin pregnancies and 6,576 neonates were included in 99,585 pregnancies. The rate of twin pregnancy was 3.3%, while the PTB rate before 37, 34, and 32 weeks among this population were 62.1, 18.8, and 10.4%, respectively. Logistic regression revealed that monochorionicity [Odds ratio (OR) 3.028, 95% confident interval (CI) 2.489–3.683, P < 0.001], gestational weight gain (GWG) <10 kg (OR 2.285, 95% CI 1.563–3.339, P < 0.001) and GWG between 10 and 15 kg (OR 1.478, 95% CI 1.188–1.839, P < 0.001), preeclampsia (PE) (OR 3.067, 95% CI 2.142–4.390, P < 0.001), and intrahepatic cholestasis of pregnancy (ICP) (OR 3.122, 95% CI 2.121–4.596, P < 0.001) were the risk factors for PTB before 37 weeks. Monochorionicity (OR 2.865, 95% CI 2.344–3.501, P < 0.001), age < 25 years (OR 1.888, 95% CI 1.307–2.728, P = 0.001), and GWG <10 kg (OR 3.100, 95% CI 2.198–4.372, P < 0.001) were risk factors for PTB before 34 weeks. Monochorionicity (OR 2.566, 95% CI 1.991–3.307, P < 0.001), age younger than 25 years (OR 1.964, 95% CI 1.265–3.048, P = 0.003), and GWG <10 kg (OR 4.319, 95% CI 2.931–6.364, P < 0.001) were the risk factors for PTB before 32 weeks.Conclusions: Monochorionicity and GWG <10 kg were two major risk factors for PTB before 32, 34, and 37 weeks, whereas maternal age, PE, and ICP were also risk factors for PTB in specific gestational age.

Determinants of cesarean mode of childbirth among Rwandan women of childbearing age: Evidence from the 2019–2020 Rwanda Demographic and Health Survey (RDHS)

“…Additionally, multiple pregnancies were identified as a risk factor for CD, which was consistent with other studies [42]. Twin pregnancies are associated with increased perinatal mortality due to a variety of factors, including prematurity-related complications and birth complications that may contribute to perinatal loss or morbidity [43]. These risk factors justify the option of planned CD to avoid such complications [44].…”

Epidemiology and factors associated with preterm births in multiple pregnancy: A retrospective cohort study

“…A p-value of < 0.05 was deemed statistically signi cant. The required sample size was determined to be 381 twin pregnancies, based on a preterm birth prevalence in twin pregnancies of 55 per 100 deliveries (13,15,17).…”

“…Preterm birth refers to any birth occurring before 37 weeks of gestation. A notable risk factor for preterm birth is chorionicity (15), with twins born from monochorionic pregnancies exhibiting higher rates of neonatal morbidity and mortality (16). Thus, multiple pregnancies present an elevated risk for maternal and perinatal complications, particularly prematurity.…”

Prediction Analysis of Preterm Neonates Mortality using Machine Learning Algorithms via Python Programming

“…For many imputations, the parameter sample posterior is set to be true and different random states are applied for each imputed dataset. Monochorionicity and GWG <10 kg are two main risk factors for PTB (Preterm births) before 32, 34, and 37 weeks, while maternal age, PE, and ICP were also risk factors for PTB in specific gestational age [15]. It should be mentioned that the firstseven7 days of admission is the danger time to death with median time of six days.…”