Incidence, risk factors, and outcomes of multifetal gestation: A prospective, single center study from Central India

Introduction: Multifetal pregnancies (MFPs) are high risk pregnancies and are associated with higher complications and adverse outcomes. Aims and Objectives: To assess the incidence, risk factors, comorbidities, and outcomes of MFPs. Materials and Method: This prospective, observational study was performed over a period of 12 months (December 2018 to November 2019) and involved 212 women with MFP admitted in antenatal ward and labor room of a tertiary care center located in Central India. Maternal characteristics including age, parity, gestational age, mode of delivery, and maternal comorbidities and complications were recorded. Finally, neonatal morbidity and mortality was studied. Results: The incidence of MFP was 1.25%, with that of twin and triplet pregnancy being 1.22% and 0.03%, respectively. Majority of the women belonged to the age group of 25-30 years (43.3%), were multigravida (53.3%), and had a gestational age of 34-36 weeks (41.03%). Women most commonly underwent vaginal delivery (58.01%). The predominantly comorbidity and complications were hypertensive disorders (36.8) and preterm labor (58.49%), respectively. Majority of the neonates had low birth weight (LBW, 80.3%). There was no significant difference between the first and second twin in terms of LBW (P-value >0.05). Perinatal mortality was statistically associated with both prematurity and LBW (both P-values <0.0001). Conclusion: Overall, MFP was associated with high maternal and perinatal morbidity and mortality. Increased parity, low SES, rural area of residence, and advancing maternal age were the major determinants of MFPs. Perinatal mortality was significantly associated with LBW and prematurity.