Complications in Multiple Gestation Pregnancies at King Abdulaziz University Hospital: A Retrospective Cross-sectional Study

Background: Multiple gestation refers to a pregnancy in which the mother carries two foetuses or more simultaneously and is considered a high-risk pregnancy with high morbidity and mortality for the mother and foetus. Aim: The aim of this study was to assess the outcomes of multiple gestation pregnancies at King Abdulaziz University Hospital (KAUH) and identify common complications and risk factors for improved clinical care. Objectives: The objectives of this study were as follows: (1) to determine the maternal and neonatal complications of multiple gestation pregnancies, (2) to assess the incidence of the most common complications and (3) to investigate the factors that affect the outcomes of multiple pregnancies. Methodology: A retrospective cross-sectional study was conducted utilising medical records of 59 mothers with multiple gestations who were managed at KAUH, Jeddah, Saudi Arabia, between 2021 and 2023. Results: Twins represented 88.1% of cases. Preterm deliveries were 93.2%, and 84.7% were delivered by caesarean section. Most maternal complications were anaemia (64.4%). Most neonatal complications were low birth weight (80.8%), jaundice (56%) and neonatal intensive care unit (NICU) admission (45.6%). Preterm delivery was significantly related to assisted reproductive technology (ART) use ( P = 0.046), pre-eclampsia ( P = 0.020), placenta previa ( P = 0.010) and parity ( P = 0.001). NICU admission was significantly associated with gestational diabetes mellitus ( P = 0.005), post-partum haemorrhage ( P = 0.019), mode of delivery ( P < 0.001), gestational age ( P = 0.021), birth weight ( P < 0.001), type of multiple gestation ( P < 0.001) and Apgar score ( P < 0.001). Conclusion: Multiple gestation pregnancies have high maternal and neonatal complication rates. Several maternal and perinatal factors impact neonatal outcomes.