Factors influencing neonatal outcomes in twin pregnancies undergoing cesarean section: a cross-sectional study

OBJECTIVE: This study aimed to evaluate maternal and fetal characteristics and factors affecting fetal outcomes in twin pregnancies delivered by cesarean section. METHODS: This was a cross-sectional study in a tertiary care referral hospital. The primary outcome was to ascertain the effects of independent factors on the 1st and 5th minute APGAR scores, neonatal intensive care unit admissions, the need for mechanical ventilation, and neonatal mortality. RESULTS: A total of 453 pregnant women and 906 newborns were included in the analysis. The final logistic regression model revealed that early gestational weeks and neonates <3rd weight percentile at the time of delivery were the most significant predictors of all poor outcome parameters in at least one of the twins (p<0.05). General anesthesia for cesarean section was associated with 1st minute APGAR<7 and the need for mechanical ventilation, and emergency surgery was correlated with the need for mechanical ventilation (p<0.05) in at least one of the twins. CONCLUSION: General anesthesia, emergency surgery, early gestational weeks, and birth weight <3rd weight percentile were strongly associated with poor neonatal outcomes in at least one of the twins delivered by cesarean section.

Automated summary

This study aimed to evaluate maternal and fetal characteristics and factors affecting fetal outcomes in twin pregnancies delivered by cesarean section. The results showed that early gestational weeks and birth weight <3rd weight percentile were the most significant predictors of poor neonatal outcomes in at least one of the twins. General anesthesia and emergency surgery were also associated with poor outcomes in at least one of the twins. Therefore, interventions should aim to optimize these factors to improve neonatal outcomes in twin pregnancies delivered by cesarean section.