Incidence and complication of multifetal pregnancy in the hospitals affliated to Shiraz University of Medical Sciences

Background: The neonates who are products of multifetal gestations have higher mortality rate than the singltons, besides they are prone to complications such as: asphyxia, prematurity, low birth weight, birth trauma, septicemia and respiratory distress syndrome (RDS). We studied the incidence of multifetal pregnancies, neonatal complications and mortality rate in this group of neonates in a prospective study in the hospitals affiliated to the Shiraz University of Medical Sciences.
Methods: We evaluated these neonates and their mothers during hospital admissions for the maternal risk factors such as maternal age, history of infertility, pregnancy related complications and drug histories, hazardous factors related to delivery such as the method of delivery and its complications and neonatal problems in neonates who were the product of multifetal pregnancy, the rate and cause of mortality, and other complications such as birth asphyxia, RDS and congenital anomalies. Finally all of the data were statistically analyzed by software package social science (SPSS).
Results: The incidence of twins was 232:10000, triplets 7: 10000. Mean gestational age in twin pregnancies was 35±3.5 weeks and mean birth weight 2184.9±606 gr; in triplets mean gestational age was 31±4 weeks and mean birth weight 1598.3±687 gr. The most common neonatal complication consisted of RDS (46.4%) which was also the leading (69%) cause of death in these neonates. There was inverse relation between the neonatal complications and birth weight, especially in asphyxic patients (p<0.001). Congenital anomalies were observed in 3% of neonates. Postnatal mortality rate was higher in normal vaginal deliveries compared to caesarean sections (p=0.04). There was no seasonal difference in the incidence of multifetal pregnancies.
Conclusion: In this study the incidence of multiple pregnancies was higher than in other studies. The mortality rate was higher in the neonates born by vaginal delivery.