Ovulation induction drugs in the recent years and modern technologies in treatment of infertility resulted in remarkable increase of multiple births. The goal of the present study was to determine the frequency of multiple births and maternal -fetal as well as neonatal complications of multiple pregnancies in Mashad during a period of 5 years. Out of 19959 deliveries, 99.3 % were singletons, 0.67 % twins and 0.015 % triplets. The incidence of twins delivery was 6.7 per 1000 (1 in 150 cases). For triplets this was 0.15 per 1000 (1 in 6666). The majority of mothers aged 20-29 years, the youngest were 15-20 years old. The incidence of multiple births decreased with increasing parity and age over 29 years. Maternal complications included premature delivery (41.6 %), preeclampsy (11 %), hemorrhage (10.2 %), infection (4.3 %), and placental detachment (1.4 %). Fetal and neonatal complications were observed in 70 % and consisted of prematurity, fetal malformations (7.9%), stillbirth (6.1 %), and multiple birth mortality (13 %). A direct relation was noticed between mother"s age and neonate"s weight. Thus, multiple pregnancy must be seen as a high risk for mother and her newborn and should be managed carefully during pregnancy and in labor.

Background: The multiple pregnancy incidence is increasing worldwide. This increased incidence is concerning to the health care system. This study aims to determine the frequency of multiple pregnancy and identify factors that affect this frequency in Tehran, Iran.Materials and Methods: This cross-sectional study included 5170 mothers in labor between July 6-21, 2015 from 103 hospitals with Obstetrics and Gynecology Wards. The questionnaire used in this study consisted of five parts: demographic characteristics; information related to pregnancy; information related to the infant; information regarding the multiple pregnancy; and information associated with infertility. We recruited 103 trained midwives to collect data related to the questionnaire from eligible participants through an interview and medical records review. Frequencies and odds ratios (OR) for the association between multiple pregnancy and the selected characteristics (maternal age, economic status, history of multiple pregnancy in first-degree relatives, and reproductive history) were computed by multiple logistic regression. Stata software, version 13 (Stata Corp, College Station, TX, USA) was used for all statistical analyses.Results: Multiple pregnancy had a prevalence of 1.48% [95% confidence interval (CI): 1.19-1.85]. After controlling for confounding variables, we observed a significant association between frequency of multiple pregnancy and mother’s age (OR=1.04, 95% CI: 1.001-1.09, P=0.044), assisted reproductive technique (ART, OR=6.11, 95% CI: 1.7- 21.97, P=0.006), and history of multiple pregnancy in the mother’s family (OR=5.49, 95% CI: 3.55-9.93, P=0.001).Conclusion: The frequency of multiple pregnancy approximated results reported in previous studies in Iran. Based on the results, we observed significantly greater frequency of multiple pregnancy in older women, those with a history of ART, and a history of multiple pregnancy in the mother’s family compared to the other variables.

Background: In vitro fertilization (IVF) is a progressing common reproduction method and if the number of transferred embryo increases, the pregnancy rate and multiple pregnancies will increase which may lead to higher medical costs and human suffering. We compared pregnancy and multiple pregnancies rate after two or three transferred embryo via IVF. Methods: From April 2003 to June 2004, 301 referred infertile women to Isfahan infertility center underwent IVF with transferring two or three good quality embryos. Results: From 298 patients, 2 and 3 embryos were transferred in 155 patients and in 143 patients, respectively. Pregnancy rate was 19.4% versus 24.5% in 2 and 3 embryos transferred patients, respectively. Twin gestations were found in 5(3.2%) of 2 embryos transferred patients and in 11(7.7%) of 3 embryos transferred patients. Discussion: Transferring two or three embryos with good quality increase the rate of twin gestations in young women, without significant improve in the chance of singleton conception.

Purpose: To determine the frequency and severity of retinopathy of prematurely (ROP) among Singleton and multiple-birth neonates referred to Farabi Eye Hospital, Tehran-Iran. Methods: We reviewed the records of 99 consecutive neonates from multiple-gestation pregnancies including 68 twins, 26 triplets and 5 quadruplets who were screened for ROP during 2002-2004.The frequency, severity and risk factors of ROP were determined. The results were compared with a group of singletons who did not differ from the multiple-birth group regarding birth weight, gestational age, oxygen therapy, respiratory distress syndrome, transfusion, sepsis, phototherapy and gender.Results: ROP was present in 12.1% of multiple-birth neonates compared to 15.1%in singletons (P=0.53). Threshold ROP was present in 6.1%of multiple-birth neonates and 7.1%of singletons (P=0.62). ROP was detected in 60% of quadruplets 9.6% of twins and triplets with threshold disease in 40% of quadruplets compared to 4.2% in twins and triplets. Logistic regression analysis revealed no statistically significant differences in frequency and severity of ROP among subgroups of multiple-gestation pregnancies (P= 0.79).Conclusion: The higher frequency of ROP among multiple-birth neonates is due to lower birth weight and gestational age but there is no significant difference between multiple-births and singletons in terms of frequency and stages of ROP. Screening for ROP in multiple pregnancy births may be conducted according to the same standard protocols as for singletons.

Background: Maternal and neonatal complications in twin and multiple pregnancies are higher than in singleton pregnancies. The purpose of this study is to investigate maternal and neonatal outcomes in twin or multiple births. Methods: In this descriptive and analytical study, 266 pregnant women with twins and multiples were selected in a goal-based manner who had medical records in Imam Khomeini Hospital in Ahwaz from March 2020 to March 2022. This study is based on the purpose of selection and then the required information was extracted from the archive department of Imam Khomeini Hospital in Ahwaz. A two-part checklist was used to collect data, and then the collected information was analyzed by descriptive and analytical statistical tests. Results:  The observations of this study show that the highest frequency of the total number of births is from March 2020 to March 2021 (6729 people), while the highest ratio of the number of twin or multiple births to the total number of births is from March 2021 to March 2022 (4. 63 percent). The frequency of stillbirths is the highest from March 2021 to March 2022 (62. 96 percent). There is a significant difference in fetal complications of twin and multiple births, premature birth, low birth weight and intrauterine growth delay between twin and multiple births (P-value<0. 05) and for fetal anomaly and death from March 2021 to March 2022. Comparison of the two years under study shows no significant difference was observed between twin and multiple births (P-value>0. 05). Pre-eclampsia was observed in 7. 8 percent for twin births and 6 percent for multiple births, which statistically has no significant difference between them (P-value=0. 331) and for diabetes, placental abruption and placenta Previa. There is a significant difference between twin and multiple births (P-value<0. 05). Conclusion: The frequency of multiple pregnancy shows an increase compared to previous studies in Iran, and prevention of premature birth and careful monitoring of the fetus can improve the outcome of twin or multiple births.