Morbidity and Mortality Patterns of Neonates Born to Multiple Pregnancies: A Prospective Observational Study

Abstract

Introduction: In the last few decades, the prevalence of multiple pregnancies has increased, and it is associated with significantly higher maternal and neonatal mortality. Aim: To determine the morbidity and mortality patterns of neonates born to multiple pregnancies. Material and Methods: Prospective observational study was undertaken on neonates who were born to a mother with multiple gestations. One hundred mother’s neonates with multiple pregnancies were consequently enrolled at a tertiary institute for six months. Morbidity and mortality patterns were analysed. The data regarding the numerical variables were summarised through percentage, average, median, and deviation patterns and comparisons of categorical data were carried out by using Pearson’s Chi-square test. Results: A total of 202 babies was delivered including two pairs of triplets. Among that two were still born and two were Intra Uterine Deaths (IUD). Most of the twin pregnancies were spontaneous and in the maternal age group of 21-25 years. The male to female ratio was almost equal and 148 (74.75 %) neonates were preterm. One hundred and seventeen (59.09%) neonates were Low Birth Weight (LBW) and 44 (22.22%) were Very Low Birth Weight (VLBW), including 85 (42.93%) Small for Gestational Age (SGA) and 43 (21.72%) were Intrauterine Growth Retardation (IUGR). Ninety-eight (49.49%) neonates’ required Neonatal Intensive Care Unit (NICU) admission with lethargy and respiratory distress being the common clinical presentation. Respiratory distress syndrome, sepsis and birth asphyxia was diagnosed in 44.9%, 24.5% and 5.1% neonates respectively while jaundice, intraventricular haemorrhage and retinopathy of prematurity were the clinical diagnosis. Perinatal mortality rate was 163.34 per 1,000 pregnancies while the neonatal mortality rate was 146.46 per 1000 live born neonates. Respiratory distress syndrome, sepsis and the intraventricular haemorrhage were the common causes of mortality. Conclusion: Prevention of prematurity and LBW neonates is the key to reduce mortality and it is the greatest challenge to paediatricians and obstetricians.

Keywords

• neonatal morbidity and mortality
• perinatal mortality
• twin neonates
• twin pregnancy.