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- Title
Associated factors with neonatal near miss in twin pregnancies in a public referral maternity unit in Brazil.
- Authors
Barbosa Lopes, Fernanda Nogueira; Mendes Gouveia, Ana Paula; Costa Carvalho, Ocília Maria; Viana Júnior, Antônio Brazil; Madeiro Leite, Álvaro Jorge; Araujo Júnior, Edward; Costa Carvalho, Francisco Herlânio
- Abstract
Objective: The aim was to analyze the factors associated with neonatal near miss (NNM) in twin pregnancies in a public referral maternity unit in Brazil. Material and Methods: This retrospective, cross-sectional study included 697 twin newborns. Cases of fetal and neonatal deaths were excluded. Neonates were divided into those meeting NNM criteria (5 min Apgar score <7, birth weight <1,500 g, gestational age at delivery <32 weeks, use of mechanical ventilation or congenital malformation, transfer before 28 days of life) and those who did not. In the bivariate analysis, the chi-square and Fisher's exact tests were used. Variables with a p-value ≤0.20 were subjected to the multiple analyses, which followed the Poisson regression model. Results: The cohort consisted of 130 (18.7%) neonates meeting NNM criteria and 567 (81.3%) with no NNM criteria after multiple analyses, the following variables were associated with NNM: no previous pregnancy, prevalence ratio (PR): 1.38 [95% confidence interval (CI), 1.03-1.85]; >3 previous pregnancies, PR: 1.93 (95% CI, 1.38-2.69); premature rupture of membranes, PR: 1.50 (95% CI, 1.70-2.12); intrauterine growth restriction, PR: 2.28 (95% CI, 1.53-3.33); premature labor, PR: 1.63 (95% CI, 1.13-2.35); resuscitation in the delivery room, PR: 1.80 (95% CI, 1.24-2.62); and transfusion of blood products, PR: 4.44 (95% CI, 3.14-6.28). Conclusion: The study findings indicate that having had 0 or >3 previous pregnancies, premature rupture of the membranes, intrauterine growth restriction, resuscitation in the delivery room, premature labor, and transfusion of blood products were associated with NNM in twin pregnancies.
- Subjects
BRAZIL; MATERNAL health services; STATISTICS; CONFIDENCE intervals; CROSS-sectional method; BLOOD transfusion; RETROSPECTIVE studies; FETAL growth retardation; FISHER exact test; PUBLIC hospitals; PREGNANCY complications; CHI-squared test; INFANT mortality; MULTIPLE pregnancy; PREMATURE labor; POISSON distribution
- Publication
Journal of the Turkish-German Gynecological Association, 2021, Vol 22, Issue 1, p12
- ISSN
1309-0399
- Publication type
Article
- DOI
10.4274/jtgga.galenos.2021.2020.0176