University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository


Family Medicine


Dr. Thomas Colletti



Purpose: This article serves as a clinical review of the impact of social determinants of health (SDoH) on twin pregnancy outcomes while understanding the importance of environmental improvements in concurrence with medical care.

Method: A PubMed and Google Scholar literature search was conducted with search terms: social determinants of health, twin pregnancy, outcomes, interventions. Seventeen pertinent articles were retrieved and served as the basis for this clinical review. Each of these articles were published within the last five years for currency.

Results: There was underlying difficulty in obtaining studies that met all inclusion criteria of each socioeconomic category as it related to pregnancy mortality and/or morbidity events. The largest studied predicator demonstrated increased incidence of maternal-fetal morbidity due to race and ethnicity minorities.

Conclusion: Various exogenous and internal factors related to the mother directly influence and complicate twin outcomes. There are notable increases in the prevalence of twin gestations over the last 40 years. Twin pregnancy may result spontaneously or from in vitro fertilization. Regardless of source or influences on conception, ethnic minorities are dispositioned to have higher risks for maternal-fetal morbidity and mortality. This risk is complicated by the standard increased physiologic maternal demand. Regional advocacy for prenatal care within these regions of ethnically diverse populations will improve outcomes.

Keywords: Twin gestation, social and structural determinants of health, morbidity, mortality, risk factors, prenatal care, birth outcomes, women’s health, equity


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