Medical

International Journal of Medical and Pharmaceutical Research

Osteomalacic Myopathy and Early Gait Changes

Abstract Background: Twin pregnancies are inherently associated with increased perinatal morbidity and mortality, largely attributable to preterm birth and low birth weight. Birth weight is a critical determinant of neonatal survival, particularly in multiple gestations, where intrauterine growth restriction and prematurity are common. Objective: To evaluate the effect of birth weight on perinatal mortality in twin pregnancies delivered at a tertiary care centre. Materials and Methods: This prospective observational study was conducted at a tertiary care hospital over the study period as defined in the thesis. A total of 100 twin pregnancies (200 neonates) were included. Birth weights were categorized into five groups: <999 g, 1000–1499 g, 1500–1999 g, 2000–2499 g, and ≥2500 g. Perinatal mortality, defined as stillbirths and early neonatal deaths, was analyzed in relation to birth weight. Data were compiled from institutional records and analyzed using descriptive statistics. Results: Of the 200 neonates, 88% had low birth weight (<2500 g). The largest proportion of neonates (33.5%) weighed between 1500–1999 g, followed by 32.5% in the 2000–2499 g category. Perinatal mortality showed a strong inverse relationship with birth weight. All 19 neonates weighing <999 g resulted in perinatal deaths (100%). Among neonates weighing 1000–1499 g, 12 perinatal deaths (48%) were observed. Mortality decreased substantially in higher weight categories, with 5.9% mortality in the 1500–1999 g group and 4.6% in 2000–2499 g group. No perinatal deaths were recorded among neonates weighing ≥2500 g. Conclusion: Birth weight is a major determinant of perinatal mortality in twin pregnancies. Extremely low and very low birth weight neonates contribute disproportionately to perinatal deaths. Strategies aimed at prolonging gestation and improving fetal growth may significantly reduce perinatal mortality in twin gestations. Keywords Twin pregnancy Birth weight Perinatal mortality Low birth weight Multiple gestation INTRODUCTION Twin pregnancies account for a small proportion of all gestations but contribute disproportionately to perinatal morbidity and mortality worldwide [1]. Advances in assisted reproductive technologies and delayed childbearing have led to a steady rise in the incidence of twin pregnancies, particularly in developing countries [2]. Despite improvements in antenatal and neonatal care, perinatal outcomes in twins remain inferior compared to singleton pregnancies. Low birth weight is one of the most significant contributors to adverse perinatal outcomes in twin gestations [3]. Twins are more likely to be born preterm and growth restricted due to shared uterine space, placental insufficiency, and increased maternal complications such as hypertensive disorders and anemia [4]. Consequently, more than half of twins weigh less than 2500 g at birth, placing them at a higher risk of stillbirth, early neonatal death, respiratory distress, sepsis, and long-term neuro-developmental impairment [5]. Perinatal mortality in twins shows a strong inverse relationship with birth weight and gestational age at delivery [6]. Extremely low birth weight (<1000 g) and very low birth weight (1000–1499 g) neonates experience the highest mortality rates, especially in resource-limited settings where access to advanced neonatal intensive care may be constrained [7]. Identifying the contribution of specific birth-weight categories to perinatal deaths is essential for targeted interventions and resource allocation.