Prevalence of Multiple Gestations, and their Maternal and Perinatal Outcomes in Dubai Hospital in 2012

Abstract

Abstract Prevalence of Multiple Gestations, and their Maternal and Perinatal Outcomes in Dubai Hospital in 2012 Dr. Heba Ismail Adan Dr. Shabnam Saquib Aim: To determine the prevalence of multiple pregnancies in Dubai Hospital in 2012 and t o analyze the adverse maternal, perinatal and neonatal outcomes associated with these pregnancies. Material & methods: This is a retrospective study involving all multiple pregnancies followed and delivered in Dubai Hospital between January 2012 and December 2012. Results: There were a total of 106 multiple gestations seen in Dubai Hospital from the period of 1 st January 2012 to 31 st December 2012. These included 97 twins and 9 triplets. This gives us a multiple birth rate of 64.3 per 1000 live births. This is much higher than any other documented multiple birth rate in the world. The mean maternal age in our study was 30.5 years +/-5.3 (SD). The commonest co-morbidity seen in these multiple gestations was prematurity (72.6%) as expected followed by diabetes (22.6%). In contrast almost 60% of mothers had no associated co-morbidities, excluding premature delivery. Half of these multiple gestations were conceived spontaneously and the rest through infertility treatment such as ovulation induction or ART. Around a third (30%) were conceived through IVF or ICSI procedures. As expected, triplets delivered more prematurely than twins. The mean gestational age of delivery for twins in our study was 34.3 weeks ± 3.7 and for triplets it was 31 weeks ±3.5. Around three quarters (72.6%) were delivered via cesarean section and the main indication (32.1%) was maternal request. 25.5% were delivered vaginally. Regarding neonatal outcome, most of the fetuses were of low birth weight (58.4%). The vast majority (93.2%) had a 5 minute Apgar score of ≥7; but the NICU admission rate was around 38%, and these were mainly in the triplet category (77% vs 33% in twins). Conclusion: Overall results from this study suggest a prevalence rate of multiple gestations much higher than other developed countries such as the US and even higher than Nigeria which so far has the highest twin birth rate in the world. This increasing burden of multiple pregnancies may be attributed to the increasing availability and affordability of assisted reproductive techniques for infertility in the UAE. Both mothers and fetuses in these pregnancies are at increased risk and this warrants increased awareness of the complications associated with these pregnancies.