head JofIMAB
Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2021, vol. 27, issue3
Subject Area: Medicine
DOI: 10.5272/jimab.2021273.3985
Published online: 29 September 2021

Original article

J of IMAB. 2021 Jul-Sep;27(3):3985-3991
Victoria Atanasova1, 2ORCID logo Corresponding Autoremail, Petar Ivanov3, 4ORCID logo, Elitsa Gyokova2, 5ORCID logo, Desislava Georgieva6ORCID logo, Lyuben Veskov1, 2ORCID logo,
1) Clinic of Neonatology, UMHAT 'Dr. G. Stranski’, Pleven, Bulgaria.
2) Department of Obstetrics and Gynecology, Medical University of Pleven, Bulgaria.
3) Clinical Institute for Reproductive Medicine, Pleven, Bulgaria.
4) Department of Biochemistry, Medical University, Pleven, Bulgaria.
5) Clinic of Obstetrics and Gynecology, UMHAT 'Dr. G. Stranski’, Pleven, Bulgaria.
6) Home of medical and social care for children, Pleven, Bulgaria.

Objective: To evaluate the outcome of the extremely low birth weight newborns (ELBWNs) from single and twin pregnancies.
Material and methods: The study lasts from 2005 to 2017 and includes all life born ELBWNs treated in University Hospital, Pleven, Bulgaria. Patients' groups: singletons (1) and twins (2); twins conceived naturally(2.1) and after assisted reproductive technologies – ART(2.2).
Results: One hundred and eighty two (182) ELBWNs are examined, 65 (35.7%) of them are twins. The twins, compared to singletons, are significantly more often conceived by ART (47.7 vs 4.3%, p<0.001) and significantly more rarely infected prenatally (18 vs 41%, p 0.002). The survival rate is 51.3% for singletons and 56.6% for twins, NS.
Survived twins (n 37) achieve later their optimal nutritive tolerance (30±11 vs 25±10 days, p 0.046), require more blood transfusions (3.6±1.9 vs 2.6±1.8 per patient, p 0.009) and longer mechanical ventilation (16±15 vs 9±12 days, p 0.03) than survival singletons (n 60).
The twins suffer more often from intraventricular haemorrhage (46 vs 18%, p 0.004), patent ductus arteriosus (35 vs 15%, p 0.02) and long-term complications (51 vs 30%, p 0.04) than singletons.
ART-twins (n 31)compared to the subgroup 2.1 (n 34) are more frequently intubated in the delivery room (81 vs. 50%, p 0.01)but suffer less frequently from nosocomial infections (53 vs. 85%, p 0.03).
Conclusions: According to our data, ELBW-twins frequently suffer from respiratory, haemorrhagic, and gastrointestinal problems than ELBW-singletons, resulting in more long-term complications.
Our study proves that ART does not influence the outcome in multiples.

Keywords: newborn, twins, extremely low birth weight, assisted reproductive technology, follow-up,

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Please cite this article as: Atanasova V, Ivanov P, Gyokova E, Georgieva D, Veskov L. Impact of multiple births on the outcome in extremely low birth weight newborns. J of IMAB. 2021 Jul-Sep;27(3):3985-3991. DOI: 10.5272/jimab.2021273.3985

Corresponding AutorCorrespondence to: Victoria Atanasova, Clinic of Neonatology, UMHAT 'Dr. G. Stranski', Pleven; Department of Obstetrics and Gynecology, Medical University of Pleven; 91, Gen. Vladimir Vazoff Str., Second Clinical Base Pleven, Bulgaria; E-mail: victoria_atanasova@yahoo.co.uk

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Received: 11 February 2021
Published online: 29 September 2021

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