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Clinical factors underlying excess risk for severe maternal morbidity include twin gestation, in vitro fertilization pregnancy, older age, black race, and immigrant status. To further examine twin pregnancy as a risk factor, investigators in France prospectively enrolled >182,300 women who gave birth, (representing about 20% of all French births annually and including 3202 twin pregnancies). Severe maternal morbidity was defined based on a composite of severe hemorrhage or hypertension, eclampsia, pulmonary embolism, stroke, organ failure, intensive care unit admission, and laparotomy after vaginal delivery.
In all, 2540 women (1.4%) experienced one or more severe maternal obstetric complications. The two most common causes were hemorrhage (…