In Brief | Risk factors for adverse outcomes in twin pregnancies: a narrative review

Originally published in The Journal of Maternal-Fetal & Neonatal Medicine

Published in July 2023 in The Journal of Maternal-Fetal & Neonatal Medicine, this study explores the increasing global prevalence of twin pregnancies associated with assisted reproductive technologies, emigration, and delayed pregnancies at advanced maternal age (AMA). Addressing the specific risks faced by twins, including elevated rates of miscarriage, stillbirth, and preterm delivery, the research aims to provide targeted evidence on unique risk factors and outcomes in twin pregnancies. Examining various factors (chorionicity, AMA, BMI, socioeconomic disparities, maternal smoking, ART use, maternal perception of fetal movement, and comorbidities like hypertensive disorders and gestational diabetes), the findings are compared with singleton pregnancies.

Even after adjusting for maternal age and chorionicity, the study revealed that twin pregnancies have heightened risks compared to singletons. Twins exhibit increased likelihoods of stillbirth (adjusted OR = 1.81), NICU admission (aOR = 1.41), preterm birth (aOR = 1.47), perinatal or neonatal mortality (RR = 5.76), admission to NICU (RR = 1.78), and preterm birth (RR = 2.27). Advanced maternal age further amplifies the probabilities of perinatal or neonatal mortality, NICU admission, and preterm birth in twin pregnancies.

Notably, in twin pregnancies, factors such as BMI, socioeconomic disparities, smoking, assisted reproductive technologies, and hypertensive disorders of pregnancy have a comparatively lesser impact on adverse outcomes than in singleton pregnancies. These findings highlight the distinctive risk factors in twin pregnancies, emphasizing the necessity for additional research to tailor guidance, enhance antenatal care, and inform public health strategies.

 

Access the original research article

Whittaker, M., Greatholder, I., Kilby, M. D., & Heazell, A. E. P. (2023). Risk factors for adverse outcomes in twin pregnancies: a narrative review. The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 36(2), 2240467. https://doi.org/10.1080/14767058.2023.224046

Back to top

Disclaimer
This article is compiled from several resources researched and compiled by the contributor. It is in no way presented as an original work.  Every effort has been made to attribute quotes and content correctly. Where possible all information has been independently verified. The Medical Education Network bears no responsibility for any inaccuracies which may occur from the use of third-party sources. If you have any queries regarding this article contact us 

Fact-checking Policy
The Medical Education Network makes every effort to review and fact-check the articles used as source material in our summaries and original material. We have strict guidelines in relation to the publications we use as our source data, favouring peer-reviewed research wherever possible. Every effort is made to ensure that the information contained here is an accurate reflection of the original material. Should you find inaccuracies, out of date content or have any additional issues with our articles, please make use of the contact us form to notify us.