Evaluation of maternal and neonatal complications in preeclamptic twin versus singleton pregnancies: a retrospective study

Abstract

PURPOSE: This study aims to compare maternal and neonatal outcomes in singleton and twin pregnancies complicated by preeclampsia, emphasizing differences between preterm and term deliveries. METHODS: This is a retrospective study conducted at "Virgen de la Arrixaca" University Hospital (Murcia, Spain), from 2009 to 2020. Maternal demographic data and maternal and neonatal outcomes were collected from hospital records. Pregnancies were stratified by delivery before and after 37 weeks of gestation. RESULTS: The study included 161 singleton pregnancies and 77 twin pregnancies, all complicated by preeclampsia. Preterm delivery rates (< 37 weeks) were significantly higher in twin compared to singletons (79.2% vs. 48.4%). The mean maternal hospital stay was longer in twins (9.0 days) than for singletons (7.6 days). Maternal complications occurred in 13.7% of singleton pregnancies and 28.6% of twin pregnancies (p = 0.006), with maternal hemorrhage more frequent in twins (22.1% vs. 9.3%; p = 0.007). Maternal complications were more common in twin pregnancies (OR = 3.13; 95%CI 1.38-7.10). Cesarean delivery (OR = 2.00; 95%CI 0.85-4.66) and BMI (OR = 0.96; 95%CI 0.90-1.03) were not associated with the maternal composite outcome. Neonatal complications occurred in 29.2% of singleton pregnancies and 30.0% of first twin and 27.3% of second twin (p = 0.890 and 0.790 respectively). Factors associated with neonatal complications included birthweight (OR 0.99; 95%CI 0.99-0.99) and delivery between 34 and 37 weeks of gestation (OR = 0.08; 95%CI 0.01-0.59) and delivery after 37 weeks of gestation (OR = 0.04; 95%CI 0.01-0.46). CONCLUSIONS: Maternal complications were more frequent in twin pregnancies complicated by preeclampsia, while neoantal complications were more likely to occur in cases of preterm preeclampsia.