title: The effect of maternal anemia on maternal and neonatal outcomes in twin pregnancies.
abstract: OBJECTIVE
  The objective of this study is to investigate the effect of second trimester anemia on maternal and perinatal outcomes in twin pregnancies.
  
  
  METHODS
  A retrospective population-based study was conducted, comparing maternal and neonatal outcomes in women carrying twins, with second trimester anemia (defined as hemoglobin < 10 g/dl) to those without anemia (defined as hemoglobin > or equal to 10 g/dl). Deliveries occurred in a tertiary medical center in 2013.
  
  
  RESULTS
  During the study period, there were 307 twin deliveries. Hemoglobin levels were available for 247 (80.4%) twins; 66 (26.7%) of these had anemia (<10 g/dl) during the second trimester. Women with second trimester anemia had a higher parity (p=0.03), and needed more blood transfusions than those with hemoglobin level > or equal to 10 g/dl (OR = 1.6; 95% CI 1.11-2.43, p < 0.001). No significant differences were noted between the groups regarding other obstetrical outcomes or regarding perinatal outcomes.
  
  
  CONCLUSIONS
  Second trimester anemia in women carrying twins is associated with a high parity and increases the risk for blood transfusions. However, in our population, maternal anemia in twin gestations does not increase the risk for adverse perinatal outcome.
authors.affiliation: a Department of Obstetrics and Gynecology, Faculty of Health Sciences , Soroka University Medical Center, Ben-Gurion University of the Negev , Beer-Sheva , Israel and.
authors.forename: Amit
authors.initials: A
authors.lastname: Kosto
authors.affiliation: a Department of Obstetrics and Gynecology, Faculty of Health Sciences , Soroka University Medical Center, Ben-Gurion University of the Negev , Beer-Sheva , Israel and.
authors.forename: Rania
authors.initials: R
authors.lastname: Okby
authors.affiliation: a Department of Obstetrics and Gynecology, Faculty of Health Sciences , Soroka University Medical Center, Ben-Gurion University of the Negev , Beer-Sheva , Israel and.
authors.forename: Maya
authors.initials: M
authors.lastname: Levy
authors.affiliation: b Department of Public Health , Ben-Gurion University of the Negev , Beer-Sheva , Israel.
authors.forename: Ruslan
authors.initials: R
authors.lastname: Sergienko
authors.affiliation: a Department of Obstetrics and Gynecology, Faculty of Health Sciences , Soroka University Medical Center, Ben-Gurion University of the Negev , Beer-Sheva , Israel and.
authors.forename: Eyal
authors.initials: E
authors.lastname: Sheiner
mesh_terms: D000328:Adult; D000740:Anemia / Q000453:epidemiology* / Q000628:therapy; D001803:Blood Transfusion / Q000706:statistics & numerical data; D004200:Diseases in Twins / Q000097:blood / Q000453:epidemiology; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D007557:Israel / Q000453:epidemiology; D010298:Parity; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000453:epidemiology* / Q000628:therapy; D059285:Pregnancy, Twin; D012189:Retrospective Studies
chemical_list: D006454:Hemoglobins
keywords: Maternal anemia; maternal morbidity; pregnancy complications; twin gestation