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Croatian Society of Gynaecology and Obstetrics, and Croatian Society of Perinatal Medicine of Croatian Medical Association
Publication Date
  • Blizanačka Trudnoća
  • Perinatalni Ishod
  • Twin Pregnancy
  • Perinatal Outcome


Objective. To identify perinatal factors and results in twin pregnancies. Methods. Deliveries of 134 pairs of twins of gestational age from 24–42 weeks were retrospectively analyzed and compared to the control group of 420 single deliveries of the same gestational age in the period from 1991 to 2001. Data on the year of labor, mother's age and parity, complications during pregnancy, gestational age, position of the child during labor, the mode of delivering, child's gender, Apgar score, birth weight and length, discordant growth, duration of labour, neonatal complications and perinatal mortality were analyzed. Results. In the fifteen-year period there have been 15298 deliveries, out of which 134 (0.88%) were twin pregnancies. There is a significant difference in the occurence of twin pregnancies according to analyzed years (0.45%–1.5%). Average life age of the women having twins was higher than of the control group (28.01±5.21 vs. 26.25±5.61 years). With regard to mothers age a considerable difference was found in the age group 30–39 (31.3% vs. 23.8%). There is a significantly higher occurence of twin pregnancies among multiparous women (72.4% vs. 54.5%). There is also higher rate of complications during pregnancy and length of hospitalization compared to the control group. Average duration of twin pregnancy is two weeks shorter than of the control group (37+5 vs. 39+5), with significantly higher preterm delivery rate (35.1% vs. 4.5%). The irregular positions of the second and first twin occur more frequently than in the control group (43.3% vs. 25.4% vs. 3.6%). Caesarean section is much more frequent at twins (45.1% vs. 17.4%), especially at those whose birth weight is less than 2500 g, at those delivered before the 37th week of gestation, and in cases of breech or transverse lie. There is a considerable difference in 1-st minute Apgar score of the first and second twin and of the control group (7.69±2.028 vs. 6.89±2.515 vs. 9.10±1.391), as well as more frequent occurence of Apgar score 7–4 and <4 in the second twin. Difference in average birth weight and length between the first (2522.49±505.74 g, 47.50±3.28 cm) and second (2477.86 ±554.03 g, 47.44±3.23 cm) twin is not significant, but ¬significantly higher in relation to the control group (3396.40±490.04 g, 50.27±1.96 cm), as well as in the birth of children less than 2500 g (47.4% vs. 1.9%). The highest prevalence of discordant growth is at the second twin whose weight is in group 1500–2500 g. There is a difference in duration of labor between twins and the control group (5.69±6.12 vs. 6.00±2.12 hours). In twins there is a much higher occurence of neonatal complications (asphyxia, intracranial bleeding, breathing disorder, respiratory distress syndrom, infection, hyperbilirubinemia, dysmaturity) compared to the control group. There is a higher rate of perinatal death of the second (75‰) and the first (52‰) twin compared to the control group (9.29‰). Conclusion. Twin pregnancy and labour are at risk because of the increased rate of preterm births, low birth weight of the newborns, irregular positions of the fetus and elevated number of stillborns or neonatal deaths. Newborns from twin pregnancies, especially the second twin, are at high risk with a high morbidity and mortality rate.

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