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Twin pregnancy raises risk for adverse neonatal outcomes arising from preterm birth, abnormal placental vascular connections (in monochorionic twins), and cord entanglement (in monoamniotic twins). Because little is known about the impact of twin pregnancy on maternal outcomes, the WHO sponsored an observational study of 4756 twin deliveries and 308,111 singleton deliveries in 29 countries with a focus on low-income countries.
Among twin versus singleton deliveries, adverse maternal outcome rates were 13.4% vs. 6.2% (severe obstetric outcomes), 1.5% vs. 0.5% (organ dysfunction), and 0.4% vs. 0.1% (maternal death; P<0.05 for all comparisons). In twin pregnancies, the most common severe obstetric complications were preeclampsia, eclampsia, and…