Outcome of twin and higher order multiple pregnancies: A comparative study.

Abstract

Background: The prevalence of higher order multiple pregnancies has been on the increase worldwide.
Objective: To compare the outcome of twin and higher order multiple pregnancies (HOM) in Lagos, Nigeria.
Methods: The hospital records of all multiple pregnancies and the babies delivered at a tertiary centre in Lagos from January 2008 to December 2012 were reviewed retrospectively. The mode of delivery, gestational age, pregnancy and neonatal outcome of the babies were recorded. The pregnancy and neonatal outcomes of twin and HOM pregnancies and the babies was compared
Results: There were 328 twin and 32 HOM pregnancies out of 9799 deliveries during the period giving a prevalence of 3.35% and 0.33% for twins and HOM pregnancies respectively. Higher order multiple pregnancies were more likely to end as preterm deliveries (97.0% vs 59.3%, p=0.000), be delivered by caesarean section (95.9% vs 64.2%, p=0.000) and at a lower gestational age (32.5+2.8weeks vs 34.9+3.7weeks, p=0.000) compared to the twin gestations. The babies from the HOM pregnancies were also significantly smaller than the twins at birth, (1806+ 571g versus 2214 + 720g, p=0.000). The perinatal mortality rate was 165 and 131 per thousand births for HOM and twins respectively (p=0.369). Overall mortality was significantly higher for HOM pregnancies (28.8%vs 19.4%, p=0.026) but when the babies were analyzed based on their gestational ages and birth weight there was no significant difference in mortality.
Conclusion: The occurrence of preterm delivery appears to be common with HOM pregnancies. However, the mortality in the two groups with comparable gestational ages and birth weights are similar.

Keywords: comparison, outcome, twins, higher order multiple pregnancies