Neonatal outcome of twins and singleton neonates: An experience from tertiary care teaching center of Eastern Maharashtra, India

Introduction: It is impossible to achieve the target of Sustainable Developmental Goal without focusing on care of twins' neonates as they are more prone for death and higher chance of long-term morbidity and neurodevelopmental handicap in survivors. Aim: To estimate the outcome among twin and singleton neonates at a tertiary care teaching center of Eastern Maharashtra. Materials and Methods: Prospective observational study was conducted on neonatal intensive care unit graduates of twin birth and simultaneously admitted singletons at Government Medical College and Hospital Nagpur from June 2020 to February 2021 (9 months). Outcome among twin and singleton neonates, and their morbidity and mortality pattern were studied. Results: A total of 210 neonates of twin birth and 870 singleton neonates were recruited. Male were dominant in both groups. Preterm and low birth weight neonates were significantly more in twins compared to singleton neonates. Twin neonates were significantly more hypothermic (P < 0.001) and hypoxic (P = 0.001) compared to singleton. Jaundice (37.62%) and respiratory distress syndrome (36.67%) were the most common diagnosis in twin neonates while sepsis (34.71%) was predominant in singleton. Sepsis (33.9%) was the most common cause of death in singleton neonates while respiratory distress syndrome (35.38%) in twin births. Length of hospital stay (P < 0.0001) and neonatal mortality were significantly higher in twin neonates compared to singleton neonates (P = 0.001). Conclusion: Sepsis is the leading cause of admission and death in singleton neonates while respiratory distress syndrome in twins. Twin neonates have significantly higher mortality and longer hospital stay because of prematurity and low birth weight.