Perinatal deaths in twin pregnancy. A five-year analysis of statewide statistics in Missouri.

Analysis of computer-stored State of Missouri birth and death records over a 5 year period revealed 3,594 twin pregnancies (1.02% of all pregnancies), which accounted for 10.1% of the perinatal deaths. The mean birth weight according to weeks of gestation was computed for the pregnancies with no complications noted prior to labor and the perinatal mortality rate was determined. Complications of pregnancy were evaluated. Low birth weight appears to be the major factor in the elevated perinatal death rate in twin pregnancy, with a significant elevation of the perinatal death rate noted with labor prior to 36 weeks, any episode of hemorrhage, or premature rupture of membranes. A more liberal use of cesarean section currently shows no effect in altering the perinatal mortality rate. Programs are suggested to increase early detection and appropriate consultation and referral of multiple pregnancies in a statewide comprehensive effort to decrease the perinatal mortality rate in twin pregnancy.