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BMC Pediatrics
Published in: BMC Pediatrics 1/2016

Open Access 01-12-2016 | Research article

The large contribution of twins to neonatal and post-neonatal mortality in The Gambia, a 5-year prospective study

Authors: Reiko Miyahara, Momodou Jasseh, Grant Austin Mackenzie, Christian Bottomley, M. Jahangir Hossain, Brian M Greenwood, Umberto D’Alessandro, Anna Roca

Published in: BMC Pediatrics | Issue 1/2016

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Abstract

Background

A high twinning rate and an increased risk of mortality among twins contribute to the high burden of infant mortality in Africa. This study examined the contribution of twins to neonatal and post-neonatal mortality in The Gambia, and evaluated factors that contribute to the excess mortality among twins.

Methods

We analysed data from the Basse Health and Demographic Surveillance System (BHDSS) collected from January 2009 to December 2013. Demographic and epidemiological variables were assessed for their association with mortality in different age groups.

Results

We included 32,436 singletons and 1083 twins in the analysis (twining rate 16.7/1000 deliveries). Twins represented 11.8 % of all neonatal deaths and 7.8 % of post-neonatal deaths. Mortality among twins was higher than in singletons [adjusted odds ratio (AOR) 4.33 (95 % CI: 3.09, 6.06) in the neonatal period and 2.61 (95 % CI: 1.85, 3.68) in the post-neonatal period]. Post-neonatal mortality among twins increased in girls (P for interaction = 0.064), being born during the dry season (P for interaction = 0.030) and lacking access to clean water (P for interaction = 0.042).

Conclusion

Mortality among twins makes a significant contribution to the high burden of neonatal and post-neonatal mortality in The Gambia and preventive interventions targeting twins should be prioritized.
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Metadata
Title
The large contribution of twins to neonatal and post-neonatal mortality in The Gambia, a 5-year prospective study
Authors
Reiko Miyahara
Momodou Jasseh
Grant Austin Mackenzie
Christian Bottomley
M. Jahangir Hossain
Brian M Greenwood
Umberto D’Alessandro
Anna Roca
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2016
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-016-0573-2

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