{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T04:01:45Z","timestamp":1746331305653,"version":"3.40.4"},"reference-count":34,"publisher":"Walter de Gruyter GmbH","issue":"4","license":[{"start":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T00:00:00Z","timestamp":1742256000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_jpm-2024-0484_abs_001\">\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To analyze maternal and neonatal morbidity and mortality in twin pregnancies, associated with the quality of prenatal and labor care, through the level of adherence to recommended protocols.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpm-2024-0484_abs_002\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This was a retrospective cohort study carried out\u00a0between 2019 and 2022 involving twin pregnancies. The\u00a0socioeconomic and demographic characteristics of the pregnant women were assessed, as well as maternal and perinatal outcomes. The association between variables was measured by the odds ratio (OR) obtained from the logistic regression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpm-2024-0484_abs_003\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The sample was constituted by 118 twin pregnancies, being 72 monochorionic (MC) and 46 dichorionic (DC). The majority of mothers (44.9\u202f%) were between 16 and 25 years old. The majority of pregnant women developed some disorder during pregnancy (69.5\u202f%). The most common neonatal complication was respiratory distress, which mainly affected the 2nd twins in both MC and DC twin pregnancies (65.8 and 52.2\u202f%, respectively). Regarding the outcome \u201ccomplications after delivery of the 1st twin\u201d, some\u00a0predictors showed statistical significance such as \u201cprofessionals responsible for prenatal care\u201d (OR=3.37) and\u00a0\u201cbreastfeeding in the first hour of life\u201d (OR=1.07). With regard to the outcome \u201cdeath of the 2nd twin\u201d, only variables related to prenatal care showed statistical significance such as \u201cmode of delivery\u201d (OR=0.25), \u201ccalcium supplementation\u201d (OR=5.81), and \u201cunit of prenatal care visits\u201d (OR=9.96).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpm-2024-0484_abs_004\">\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>MC twin pregnancies had more adverse perinatal outcomes than DC twin pregnancies. In addition, adherence to prenatal care and labor protocols for twin pregnancies was associated with the outcomes studied, such as complications after delivery and death.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/jpm-2024-0484","type":"journal-article","created":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T04:20:31Z","timestamp":1742185231000},"page":"467-477","source":"Crossref","is-referenced-by-count":0,"title":["Prenatal care for twin pregnancies: analysis of maternal and neonatal morbidity and mortality"],"prefix":"10.1515","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9232-7155","authenticated-orcid":false,"given":"Isabelle Cordeiro de Nojosa","family":"Sombra","sequence":"first","affiliation":[{"name":"Department of Obstetrics , Paulista School of Medicine\u00a0\u2013 Federal University of S\u00e3o Paulo (EPM-UNIFESP) , S\u00e3o Paulo , SP , Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6145-2532","authenticated-orcid":false,"given":"Edward","family":"Araujo J\u00fanior","sequence":"additional","affiliation":[{"name":"Department of Obstetrics , Paulista School of Medicine\u00a0\u2013 Federal University of S\u00e3o Paulo (EPM-UNIFESP) , S\u00e3o Paulo , SP , Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1514-5504","authenticated-orcid":false,"given":"Julio","family":"Elito J\u00fanior","sequence":"additional","affiliation":[{"name":"Department of Obstetrics , Paulista School of Medicine\u00a0\u2013 Federal University of S\u00e3o Paulo (EPM-UNIFESP) , S\u00e3o Paulo , SP , Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2025,3,18]]},"reference":[{"key":"2025050303033121128_j_jpm-2024-0484_ref_001","doi-asserted-by":"crossref","unstructured":"Santana, DS, Surita, FG, Cecatti, JG. Multiple pregnancy: epidemiology and association with maternal and perinatal morbidity. Rev Bras Ginecol Obstet 2018;40:554\u201362. https:\/\/doi.org\/10.1055\/s-0038-1668117.","DOI":"10.1055\/s-0038-1668117"},{"key":"2025050303033121128_j_jpm-2024-0484_ref_002","doi-asserted-by":"crossref","unstructured":"Esposito, G, Dalmartello, M, Franchi, M, Mauri, PA, Cipriani, S, Corrao, G, et al.. Trends in dizygotic and monozygotic spontaneous twin births during the period 2007\u20132017 in Lombardy, Northern Italy: a population-based study. Twin Res Hum Genet 2022;25:149\u201355. https:\/\/doi.org\/10.1017\/thg.2022.19.","DOI":"10.1017\/thg.2022.19"},{"key":"2025050303033121128_j_jpm-2024-0484_ref_003","doi-asserted-by":"crossref","unstructured":"Rissanen, AS, Gissler, M, Nupponen, IK, Nuutila, ME, Jernman, RM. Perinatal outcome of dichorionic and monochorionic-diamniotic Finnish twins: a historical cohort study. Acta Obstet Gynecol Scand 2022;101:153\u201362. https:\/\/doi.org\/10.1111\/aogs.14285.","DOI":"10.1111\/aogs.14285"},{"key":"2025050303033121128_j_jpm-2024-0484_ref_004","doi-asserted-by":"crossref","unstructured":"Kim, MJ, Kim, HM, Cha, HH, Kim, H, Kim, HS, Lim, BS, et al.. Perinatal outcomes and neurodevelopment 1 year after birth in discordant twins according to chorionicity. Medicina (Kaunas) 2023;59:493. https:\/\/doi.org\/10.3390\/medicina59030493.","DOI":"10.3390\/medicina59030493"},{"key":"2025050303033121128_j_jpm-2024-0484_ref_005","doi-asserted-by":"crossref","unstructured":"Wong, PC, Kitsantas, P. A review of maternal mortality and quality of care in the USA. J Matern Fetal Neonatal Med 2020;33:3355\u201367. https:\/\/doi.org\/10.1080\/14767058.2019.1571032.","DOI":"10.1080\/14767058.2019.1571032"},{"key":"2025050303033121128_j_jpm-2024-0484_ref_006","doi-asserted-by":"crossref","unstructured":"Almadhoob, A, Ohlsson, A. Sound reduction management in the neonatal intensive care unit for preterm or very low birth weight infants. Cochrane Database Syst Rev 2020;1:CD010333. https:\/\/doi.org\/10.1002\/14651858.CD010333.pub3.","DOI":"10.1002\/14651858.CD010333.pub3"},{"key":"2025050303033121128_j_jpm-2024-0484_ref_007","unstructured":"Kaini, NR, Chaudhary, D, Adhikary, V, Bhattacharya, S, Lamsal, M. Overview of cases and prevalence of jaundice in neonatal intensive care unit. Nepal Med Coll J 2006;8:133\u20135."},{"key":"2025050303033121128_j_jpm-2024-0484_ref_008","doi-asserted-by":"crossref","unstructured":"S\u00e1nchez Garc\u00eda, L, Pellicer, A, L\u00f3pez-Mart\u00ednez, C, Garc\u00eda-Garc\u00eda, ML, Casas, I, Pozo, F, et al.. Respiratory morbidity associated with viral respiratory infections during neonatal stage in premature infants. Pediatr Pulmonol 2021;56:967\u201373. https:\/\/doi.org\/10.1002\/ppul.25241.","DOI":"10.1002\/ppul.25241"},{"key":"2025050303033121128_j_jpm-2024-0484_ref_009","doi-asserted-by":"crossref","unstructured":"Demitto, MO, Gravena, AA, Dell\u2019Agnolo, CM, Antunes, MB, Pelloso, SM. High risk pregnancies and factors associated with neonatal death. Rev Esc Enferm USP 2017;51:e03208. https:\/\/doi.org\/10.1590\/s1980-220x2016127103208.","DOI":"10.1590\/s1980-220x2016127103208"},{"key":"2025050303033121128_j_jpm-2024-0484_ref_010","doi-asserted-by":"crossref","unstructured":"Khalil, A, Liu, B. Controversies in the management of twin pregnancy. Ultrasound Obstet Gynecol 2021;57:888\u2013902. https:\/\/doi.org\/10.1002\/uog.22181.","DOI":"10.1002\/uog.22181"},{"key":"2025050303033121128_j_jpm-2024-0484_ref_011","doi-asserted-by":"crossref","unstructured":"Hiersch, L, Attali, E, Melamed, N. Special considerations regarding antenatal care and pregnancy complications in dichorionic twin pregnancies. Am J Obstet Gynecol MFM 2022;4:100500. https:\/\/doi.org\/10.1016\/j.ajogmf.2021.100500.","DOI":"10.1016\/j.ajogmf.2021.100500"},{"key":"2025050303033121128_j_jpm-2024-0484_ref_012","doi-asserted-by":"crossref","unstructured":"Ochsenbein-K\u00f6lble, N. Twin pregnancies. Ultraschall Med 2021;42:246\u201369. https:\/\/doi.org\/10.1055\/a-1344-4812.","DOI":"10.1055\/a-1344-4812"},{"key":"2025050303033121128_j_jpm-2024-0484_ref_013","doi-asserted-by":"crossref","unstructured":"Gordijn, SJ, Beune, IM, Thilaganathan, B, Papageorghiou, A, Baschat, AA, Baker, PN, et al.. Consensus definition of fetal growth restriction: a Delphi procedure. Ultrasound Obstet Gynecol 2016;48:333\u20139. https:\/\/doi.org\/10.1002\/uog.15884.","DOI":"10.1002\/uog.15884"},{"key":"2025050303033121128_j_jpm-2024-0484_ref_014","doi-asserted-by":"crossref","unstructured":"Capurro, H, Korichzky, S, Fonseca, O, Caldeiro-Barcia, R. A simplified method for diagnosis of gestational age in the newborn enfant. J Pediatr 1978;93:120\u20132.","DOI":"10.1016\/S0022-3476(78)80621-0"},{"key":"2025050303033121128_j_jpm-2024-0484_ref_015","doi-asserted-by":"crossref","unstructured":"Chauhan, SP, Scardo, JA, Hayes, E, Abuhamad, AZ, Berghella, V. Twins: prevalence, problems, and preterm births. Am J Obstet Gynecol 2010;203:305\u201315. https:\/\/doi.org\/10.1016\/j.ajog.2010.04.031.","DOI":"10.1016\/j.ajog.2010.04.031"},{"key":"2025050303033121128_j_jpm-2024-0484_ref_016","unstructured":"Minist\u00e9rio da Sa\u00fade. DATASUS. Tabnet. Bras\u00edlia, DF. Minist\u00e9rio da Sa\u00fade 2020. Available from: https:\/\/datasus.saude.gov.br\/informacoes-de-saude-tabnet\/."},{"key":"2025050303033121128_j_jpm-2024-0484_ref_017","doi-asserted-by":"crossref","unstructured":"Rottenstreich, M, Rotem, R, Glick, I, Reichman, O, Rottenstreich, A, Grisaru-Granovsky, S, et al.. Maternal and neonatal outcomes in twin deliveries with prolonged second-stage duration of the presenting twin: a retrospective cohort study. Reprod Sci 2022;29:143\u201353. https:\/\/doi.org\/10.1007\/s43032-021-00798-7.","DOI":"10.1007\/s43032-021-00798-7"},{"key":"2025050303033121128_j_jpm-2024-0484_ref_018","doi-asserted-by":"crossref","unstructured":"Chen, P, Li, M, Mu, Y, Wang, Y, Liu, Z, Li, Q, et al.. Temporal trends and adverse perinatal outcomes of twin pregnancies at differing gestational ages: an observational study from China between 2012-2020. BMC Pregnancy Childbirth 2022;22:467. https:\/\/doi.org\/10.1186\/s12884-022-04766-0.","DOI":"10.1186\/s12884-022-04766-0"},{"key":"2025050303033121128_j_jpm-2024-0484_ref_019","doi-asserted-by":"crossref","unstructured":"Assis, TSC, Martinelli, KG, Gama, SGN, Santos Neto, ET. Associated factors of neonatal near miss among newborns of adolescent mothers in Brazil. Rev Esc Enferm USP 2022;56:e20210359. https:\/\/doi.org\/10.1590\/1980-220x-reeusp-2021-0359en.","DOI":"10.1590\/1980-220x-reeusp-2021-0359en"},{"key":"2025050303033121128_j_jpm-2024-0484_ref_020","doi-asserted-by":"crossref","unstructured":"Prins, TJ, Min, AM, Gilder, ME, Tun, NW, Schepens, J, McGregor, K, et al.. Comparison of perinatal outcome and mode of birth of twin and singleton pregnancies in migrant and refugee populations on the Thai Myanmar border: a population cohort. PLoS One 2024;19:e0301222. https:\/\/doi.org\/10.1371\/journal.pone.0301222.","DOI":"10.1371\/journal.pone.0301222"},{"key":"2025050303033121128_j_jpm-2024-0484_ref_021","doi-asserted-by":"crossref","unstructured":"Roman, A, Ramirez, A, Fox, NS. Prevention of preterm birth in twin pregnancies. Am J Obstet Gynecol MFM 2022;4:100551. https:\/\/doi.org\/10.1016\/j.ajogmf.2021.100551.","DOI":"10.1016\/j.ajogmf.2021.100551"},{"key":"2025050303033121128_j_jpm-2024-0484_ref_022","doi-asserted-by":"crossref","unstructured":"Alberton, M, Rosa, VM, Iser, BPM. Prevalence and temporal trend of prematurity in Brazil before and during the covid-19 pandemic: analysis from the 2011-2021 historical series. Epidemiol Serv Saude 2023;32:e2022603. https:\/\/doi.org\/10.1590\/s2237-96222023000200005.","DOI":"10.1590\/s2237-96222023000200005"},{"key":"2025050303033121128_j_jpm-2024-0484_ref_023","doi-asserted-by":"crossref","unstructured":"Fujita, MM, Brizot, ML, Liao, AW, Bern\u00e1th, TN, Cury, L, Neto, JDB, et al.. Reference range for cervical length in twin pregnancies. Acta Obstet Gynecol Scand 2002;81:856\u20139. https:\/\/doi.org\/10.1034\/j.1600-0412.2002.810910.x.","DOI":"10.1034\/j.1600-0412.2002.810910.x"},{"key":"2025050303033121128_j_jpm-2024-0484_ref_024","doi-asserted-by":"crossref","unstructured":"De Vito, M, Cetraro, J, Capannolo, G, Alameddine, S, Patelli, C, D\u2019Antonio, F, et al.. Cervical length as a screening tool for preterm birth in twin pregnancies: a systematic review and critical evaluation of quality clinical practice guidelines. J Perinat Med 2023;52:262\u20139. https:\/\/doi.org\/10.1515\/jpm-2023-0262.","DOI":"10.1515\/jpm-2023-0262"},{"key":"2025050303033121128_j_jpm-2024-0484_ref_025","doi-asserted-by":"crossref","unstructured":"Saccone, G, Ciardulli, A, Xodo, S, Dugoff, L, Ludmir, J, D\u2019Antonio, F, et al.. Cervical pessary for preventing preterm birth in twin pregnancies with short cervical length: a systematic review and meta-analysis. J Matern Fetal Neonatal Med 2017;30:2918\u201325. https:\/\/doi.org\/10.1080\/14767058.2016.1268595.","DOI":"10.1080\/14767058.2016.1268595"},{"key":"2025050303033121128_j_jpm-2024-0484_ref_026","doi-asserted-by":"crossref","unstructured":"Murgano, D, Khalil, A, Prefumo, F, Mieghem, TV, Rizzo, G, Heyborne, KD, et al.. Outcome of twin-to-twin transfusion syndrome in monochorionic monoamniotic twin pregnancy: systematic review and meta-analysis. Ultrasound Obstet Gynecol 2020;55:310\u201317. https:\/\/doi.org\/10.1002\/uog.21889.","DOI":"10.1002\/uog.21889"},{"key":"2025050303033121128_j_jpm-2024-0484_ref_027","doi-asserted-by":"crossref","unstructured":"Buca, D, Pagani, G, Rizzo, G, Familiari, A, Flacco, ME, Manzoli, L, et al.. Outcome of monochorionic twin pregnancy with selective intrauterine growth restriction according to umbilical artery Doppler flow pattern of smaller twin: systematic review and meta-analysis. Ultrasound Obstet Gynecol 2017;50:559\u201368. https:\/\/doi.org\/10.1002\/uog.17362.","DOI":"10.1002\/uog.17362"},{"key":"2025050303033121128_j_jpm-2024-0484_ref_028","doi-asserted-by":"crossref","unstructured":"Rizzo, G, Arduini, D, Romanini, C. Cardiac and extracardiac flows in discordant twins. Am J Obstet Gynecol 1994;170:1321\u20137. https:\/\/doi.org\/10.1016\/s0002-9378(13)90458-0.","DOI":"10.1016\/S0002-9378(94)70150-4"},{"key":"2025050303033121128_j_jpm-2024-0484_ref_029","doi-asserted-by":"crossref","unstructured":"Ghi, T, Prefumo, F, Fichera, A, Lanna, M, Periti, E, Persico, N, et al.. Development of customized fetal growth charts in twins. Am J Obstet Gynecol 2017;216:514.e1\u2013514.e17. https:\/\/doi.org\/10.1016\/j.ajog.2016.12.176.","DOI":"10.1016\/j.ajog.2016.12.176"},{"key":"2025050303033121128_j_jpm-2024-0484_ref_030","doi-asserted-by":"crossref","unstructured":"Sanders, LSC, Pinto, FJM, Medeiros, CRB, Sampaio, RMM, Viana, RAA, Lima, KJ. [Infant mortality: analysis of associated factors in a capital of Northeast Brazil]. Cad Sa\u00fade Colet 2017;25:83\u20139. https:\/\/doi.org\/10.1590\/1414-462x201700010284.","DOI":"10.1590\/1414-462x201700010284"},{"key":"2025050303033121128_j_jpm-2024-0484_ref_031","doi-asserted-by":"crossref","unstructured":"Bellizzi, S, Sobel, H, Betran, AP, Temmerman, M. Early neonatal mortality in twin pregnancy: findings from 60 low- and middle-income countries. J Glob Health 2018;8:010404. https:\/\/doi.org\/10.7189\/jogh.08.010404.","DOI":"10.7189\/jogh.08.010404"},{"key":"2025050303033121128_j_jpm-2024-0484_ref_032","doi-asserted-by":"crossref","unstructured":"Torres, JA, Domingues, RM, Sandall, J, Hartz, Z, Gama, SG, Theme Filha, MM, et al.. Caesarean section and neonatal outcomes in private hospitals in Brazil: comparative study of two different perinatal models of care. Cad Saude Publica 2014;30:S1\u201312. https:\/\/doi.org\/10.1590\/0102-311x00129813.","DOI":"10.1590\/0102-311X00129813"},{"key":"2025050303033121128_j_jpm-2024-0484_ref_033","doi-asserted-by":"crossref","unstructured":"Narang, K, Szymanski, LM. Multiple gestations and hypertensive disorders of pregnancy: what do we know? Curr Hypertens Rep 2020;23:1. https:\/\/doi.org\/10.1007\/s11906-020-01107-4.","DOI":"10.1007\/s11906-020-01107-4"},{"key":"2025050303033121128_j_jpm-2024-0484_ref_034","doi-asserted-by":"crossref","unstructured":"D\u2019Antonio, F, Khalil, A, Rizzo, G, Fichera, A, Herrera, M, Buca, D, et al.. Aspirin for prevention of preeclampsia and adverse perinatal outcome in twin pregnancies: a systematic review and meta-analysis. Am J Obstet Gynecol MFM 2023;5:100803. https:\/\/doi.org\/10.1016\/j.ajogmf.2022.100803.","DOI":"10.1016\/j.ajogmf.2022.100803"}],"container-title":["Journal of Perinatal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/jpm-2024-0484\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/jpm-2024-0484\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,3]],"date-time":"2025-05-03T03:06:37Z","timestamp":1746241597000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/jpm-2024-0484\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,18]]},"references-count":34,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,4,2]]},"published-print":{"date-parts":[[2025,5,26]]}},"alternative-id":["10.1515\/jpm-2024-0484"],"URL":"https:\/\/doi.org\/10.1515\/jpm-2024-0484","relation":{},"ISSN":["0300-5577","1619-3997"],"issn-type":[{"type":"print","value":"0300-5577"},{"type":"electronic","value":"1619-3997"}],"subject":[],"published":{"date-parts":[[2025,3,18]]}}}