Multiple Gestations: Neonatal and Maternal Characteristics

Multiple gestation neonates are commonly found in older age women along with increasing use of assisted reproductive techniques. They are at an increased risk of complications and also impose financial, emotional, social, and psychological burdens on the family. There is a paucity of studies on multiple gestations in India, hence this study was conducted to evaluate the clinical profile and associated comorbidities in neonates born through multiple gestations which can help in anticipating, preparing, and managing possible complications. This was a prospective observational study conducted in a Level III neonatal intensive care unit of a tertiary care hospital. All intramural neonates delivered with multiple gestations were included. Data regarding the antenatal, perinatal, and hospital course of the neonates were documented. A total of 75 intramural neonates (36 twins and 1 triplet) were enrolled in the study. About 67.6% were delivered via caesarean section and 81.1% were spontaneous conception. The most common maternal complications observed were hyperemesis gravidarum (56.76%) followed by pregnancy-induced hypertension (PIH) (40.54%). About 80% of twin neonates were diamniotic dichorionic (DADC) and 42% of twin neonates had vertex-vertex presentation. Almost 22.7% of neonates required neonatal resuscitation and 98% had a birth weight <2.5 kg. Initiation of breastfeeding was delayed, and longer hospital stay was observed in preterm neonates with birth weight ≤1.5 kg and birth weight discordance. Multiple gestations are associated with significant neonatal complications owing to prematurity and low birth weight. Thorough knowledge of these complications helps in better fetal and neonatal surveillance and prevention of adverse outcomes.