Impact of fetal sex combinations on maternal, pregnancy, and neonatal outcomes in dichorionic twin pregnancies

Aims: The aim of this study was to investigate the impact of concordance and discordance in fetal sex on maternal, pregnancy, and neonatal outcomes in dichorionic twin pregnancies. Methods: This retrospective cohort analysis includes DCDA twin pregnancies delivered at Ankara Etlik City Hospital from January 2023 to December 2024. Pregnancies were categorized into three distinct groups according to the combinations of fetal gender: male-male (group 1), female-female (group 2), and male-female (group 3). Maternal demographic, pregnancy, and neonatal outcome data were compared. Composite adverse perinatal outcome (CAPO) was defined as severe neonatal complications. Chi-square, one-way ANOVA, Kruskal-Wallis, and post-hoc analyses were applied with confounder adjustment. Results: Male-male pregnancies were also characterized by significantly increased maternal age, BMI, parity, and diabetic disease rates compared with female-female pregnancies (p