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Urelija Rodin*, Željka Draušnik,** Ivan Cerovečki***

Croatian Institut of Public Health School of Public Health dr. Andrija Štampar,
School of Medicine University of Zagreb*, Croatian Institut of Public Health**

Key words: twin pregnancies, perinatal mortality, perinatal death causes

SUMMARY. Twin pregnancies are associated with numerous risk factors that may result in serious complications of pregnancy and adverse perinatal outcomes, including stillbirth or neonatal death. In order to assess perinatal death rates pertaining to twin pregnancies in Croatia, we conducted an analysis of data on childbirth and pregnancy outcomes recorded in Croatia in 2017, using the Croatian Institute of Public Health childbirth database. The objectives of this study were to determine the frequency of twin pregnancies in relation to maternal age, analyze the gestational age distribution at childbirth and delivery methods used in twin pregnancies, and analyze perinatal mortality rates and causes of perinatal death in twin pregnancies. A total of 36,033 births with 36,662 children delivered were recorded in Croatian maternities in 2017. Singleton births made up for 98.28% of all births, whereas twin births and triplet births amounted to 1.69% and 0.03% respectively. 84.7% of the total number of perinatal deaths (188/222) was recorded in singleton births; 13.1% of perinatal deaths (29) were recorded in twins and 2.2% (5) in triplets. Women delivering twins were on the average a year and a half older than women delivering singletons (31.6 y. : 30,1 y., respectively). 93.4% of singleton deliveries were term deliveries; with regard to twin pregnancies, there was a roughly equal distribution of deliveries in the 32 – 36 weeks and 37 – 41 weeks gestational age groups. The total perinatal death rate was 5.31 per 1000 live births for singletons and 23.81 for twins. The highest perinatal death rate was recorded in newborns in < 500 g and 500 – 999 g birth weight groups. With regard to gestational age, the perinatal death rate for twins was higher in comparison to singletons only in the term delivery group. The leading causes of perinatal deaths were infections, short duration of gestation and low birth weight with consequent immaturiry, as well as congenital malformations. There were no significant differences in perinatal death causes between singletons and twins except for a higher frequency of intrauterine growth restriction in twins.