Maternal and perinatal outcomes of deliveries at amana regional referral hospital “dar es salaam, Tanzania”

Background: Multiple pregnancies are commonly accompanied by adverse maternal and fetal outcomes. Common adverse maternal outcomes are postpartum haemorrhage, pregnancy-induced hypertension, premature rupture of membranes, anaemia, antepartum haemorrhage, and delivery by cesarean section considering the presentation of the first twin. Perinatal outcomes of interest were prematurity, low birth weight, birth asphyxia, congenital anomalies, perinatal death, and admission to the neonatal unit. These adverse outcomes are seen more in the multiple pregnancies than in the singleton pregnancies. This study assessed the proportion of multiple and singleton pregnancies and associated outcomes among women delivering at Amana Regional Referral Hospital, in Dar es Salaam from July 2022 to February 2023. Materials and Methods: A cross-section descriptive study was conducted from July 2022 to February 2023 at Amana Regional Referral Hospital, involving a total of 751 women of which 251 were multiple pregnancies. 500 women with singleton pregnancies were recruited from 15th November to 15th December 2023. Data were obtained using a structured questionnaire and from partographs and registered books of labour wards and were analyzed using the Statistical Package for Social Sciences (SPSS) Version 23. Bivariate and multivariate logistic regressions were done and outcomes of maternal and neonatal with a p-value of < 0.05 were considered statistically significant. Results: The proportion of multiple pregnancies at Amana Regional Referral Hospital was 2.6% from July 2022 to February 2023. The adverse maternal outcomes observed were: Postpartum haemorrhage was 10.4% (AOR 4.95 95% CI = (2.42 – 10.12) preterm delivery 27.9% (AOR 2.04 95% CI = (1.40 – 2.97) and delivery by caesarean section was 35.1% (AOR 2.16 95% CI = 1.50 – 3.12). Neonatal admission was 24.8% (AOR 7.38 95% CI = (3.34 – 18.35), low birth weight was 29% AOR 31.25 95% CI = (5.81 – 168.12) Perinatal death was 4.2% (AOR 12.10 95% CI 1.49 – 101.52) and Prematurity was 28.2% (AOR 6.65 95% CI = (2.27 – 19.45). Conclusion: Premature delivery, delivery by caesarean section, and postpartum haemorrhage were adverse maternal outcomes to the multiples than singletons, and for the neonates adverse outcomes were low birth weight, prematurity, and perinatal death were more to the multiples than to singletons. Therefore; with an increased proportion of multiple pregnancies early diagnosis of twin pregnancy is important to take care of the women to minimize the anticipated adverse outcomes.