Perinatal outcomes in twin pregnancies complicated by maternal morbidity: evidence from the WHO Multicountry Survey on Maternal and Newborn Health

Table 4 Factors independently associated with Acute Adverse Perinatal Outcome (AcAPO) and with any Adverse Perinatal Outcome (APO) by Poisson multiple regression analysis. WHO Multicountry Survey, 2010–2011

Model/ Variables	PR_adj	95% CI	p
AcAPO [n = 283,549]
Gestational age at delivery (weeks)	0.81	0.80–0.82	< 0.001
Maternal complications (PLTC, MNM, MD)	1.88	1.76–2.02	< 0.001
Group (Twin)	1.50	1.40–1.61	< 0.001
Mode of delivery (Vaginal)	0.64	0.58–0.70	< 0.001
Parity (≥1)	0.86	0.81–0.91	< 0.001
Marital status (With no partner)	1.43	1.12–1.83	0.004
Maternal education (Up to nine years)	1.18	1.04–1.33	0.011
Maternal age (years)	1.006	1.001–1.011	0.014
APO [n = 283,393]
Group (Twin)	1.87	1.78–1.97	< 0.001
Maternal complications (PLTC, SMM, MD)	1.39	1.32–1.46	< 0.001
Parity (≥1)	0.82	0.80–0.85	< 0.001
Gestational age at delivery (weeks)	0.96	0.95–0.97	< 0.001
Maternal education (Up to nine years)	1.23	1.15–1.32	< 0.001
Maternal age (years)	0.99	0.986–0.994	< 0.001

AcAPO Acute Adverse Perinatal Outcome (Apgar score at 5th min < 7 OR Perinatal death OR NICU admission)
APO any Adverse Perinatal Outcome (Apgar score at 5th min < 7 OR Perinatal death OR NICU admission OR SGA)
PR_adj = prevalence ratio adjusted for cluster effect; 95% CI: 95% confidence interval for prevalence ratio
Poisson multiple regression analysis, controlled by: Group (Single:0; Twin: 1); Age (years); Maternal education (Up to nine years: 1; > 10 years: 0); Parity (0/≥1: 1); Marital status (With no partner: 1/With partner: 0); Gestational age at delivery (weeks); Onset of labor (Spontaneous: 0; Other: 1); Mode of delivery (Vaginal: 1; C-section: 0); Maternal complications (No complication: 0/PLTC, MNM, MD: 1)

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