Maternal Risk Factors and Neonatal Complications of Twins

Background:- Twin pregnancy is high risk pregnancy and lead to maternal and neonatal morbidity and mortality so need special care to avoid these complications if it is possible. Aim of study:- To study the maternal risk factors of twin pregnancy, to study the neonatal complications and its occurrence in 1st or 2nd born neonates and to study the relationship between these complications and mode of delivery. Patients and methods:- This is cross sectional study done in Al-Kadhymia teaching hospital in neonatal care unit, pediatric ward and maternity department in the period between 1st February to 1st September 2010 included 50 pairs of twins, the mothers of these twins were submitted for detailed maternal history and each neonate was submitted for thorough physical examination, laboratory investigations and follow up. Results:- From total 50 pregnant women, 21 women were in age between (31-35year), 39 women in weight group between (65-75kg), 36 women in height group between (160-170cm), 37 women from urban area, 26 women without any family history of twins, 42 women without any history of using of any methods of induction of ovulation. From a total 100 neonates, males were 61(61%) and female were 39(39%), thirty three (66%) were delivered by CS and seventeenth (34%) were by NVD, thirty six (72%) were preterm (gestational age less than 37week) and the remaining were term (gestational age equal or more than 37week). The neonatal complications were respiratory distress syndrome 52, neonatal jaundice 43, sepsis23, intra uterine growth restriction 11, congenital anomalies 7, hypoglycemia 7, birth asphyxia 5, birth trauma 4, anemia 3 and polycythemia 1. The neonatal complications of 1st and 2nd twins were respectively as following respiratory distress syndrome (15,37), jaundice(15,27),sepsis(6,17), IUGR(4,7), congenital anomalies(1,6), hypoglycemia (0,7), birth asphyxia(1,4), birth trauma(1,3), anemia(2,1) and Polycythemia (0,1). Conclusions:- Twin pregnancy is high risk pregnancy, directly proportional with maternal age and the family history of twin pregnancy was more related to maternal side than paternal side, second born twin is more liable for complications than first twin, prematurity was a dangerous complication and need special care followed by respiratory distress syndrome and jaundice, these complications occurred more commonly with cesarean section delivered twins.