Prenatal care for twin pregnancies: analysis of maternal and neonatal morbidity and mortality.

Abstract

Objectives: To analyze maternal and neonatal morbidity and mortality in twin pregnancies, associated with the quality of prenatal and labor care, through the level of adherence to recommended protocols.

Methods: This was a retrospective cohort study carried out between 2019 and 2022 involving twin pregnancies. The socioeconomic and demographic characteristics of the pregnant women were assessed, as well as maternal and perinatal outcomes. The association between variables was measured by the odds ratio (OR) obtained from the logistic regression.

Results: The sample was constituted by 118 twin pregnancies, being 72 monochorionic (MC) and 46 dichorionic (DC). The majority of mothers (44.9 %) were between 16 and 25 years old. The majority of pregnant women developed some disorder during pregnancy (69.5 %). The most common neonatal complication was respiratory distress, which mainly affected the 2nd twins in both MC and DC twin pregnancies (65.8 and 52.2 %, respectively). Regarding the outcome "complications after delivery of the 1st twin", some predictors showed statistical significance such as "professionals responsible for prenatal care" (OR=3.37) and "breastfeeding in the first hour of life" (OR=1.07). With regard to the outcome "death of the 2nd twin", only variables related to prenatal care showed statistical significance such as "mode of delivery" (OR=0.25), "calcium supplementation" (OR=5.81), and "unit of prenatal care visits" (OR=9.96).

Conclusions: MC twin pregnancies had more adverse perinatal outcomes than DC twin pregnancies. In addition, adherence to prenatal care and labor protocols for twin pregnancies was associated with the outcomes studied, such as complications after delivery and death.