Relationship of maternal factors and obstetric complications with term singleton vs term twin neonatal outcomes: A retrospective study in China

BACKGROUND: Neonatal birth weight and length are important indicators of neonatal survival and morbidity during later life and are influenced by maternal factors and obstetrical complications. Therefore, we aimed to determine the relationship of maternal factors and obstetric complications with term singleton vs term twin neonatal outcomes in Wuhan University Renmin Hospital, Hubei, China. METHODS: A total of 10517 neonatal births were recorded in a tertiary-hospital-based retrospective study and term singleton (n=7787) and term twins (n=169) were included for data analysis. Birth weight and birth length were measured immediately after birth. Correlation, independent student t-test, and backward multiple linear regression were used for statistical analysis. RESULTS: Women with singleton gestation have an increased rate of obstetric complications compared to women with twin gestation. However, a higher frequency of cesarean section and breech were found in twin gestation compared to singleton gestation. Weight before pregnancy, gestational weight gain, and gestational diabetes mellitus were significantly positive (p<0.05) associated with singleton neonatal birth length and weight. In contrast, preeclampsia, placenta previa, oligohydramnios, premature rupture of membrane, breech, and multiparity had a significantly negative (p<0.05) association with singleton neonatal birth length and weight. Maternal age was significantly positive (p<0.05) associated with only singleton neonatal birth weight. Moreover, the nuchal cord was significantly positive (p<0.05) associated with singleton neonatal birth length. On the other hand, maternal age and multiparity were significantly positive (p<0.05) associated with twins' neonatal birth length and weight. Furthermore, gestational weight gain was significantly positive (p<0.05) associated with only twins' neonatal birth weight. CONCLUSION: In term gestation, obstetric complications were significantly associated with singleton birth size rather than twin birth size.