Determinants of Perinatal Mortality in Twins at Ibadan

Abstract

Context: Twinning being a very important high-risk condition in our environment requires detailed study. There are several studies reviewing factors in twin perinatal mortality in our environment but there is a need to ascertain the relative contributions of each of these factors.


Objectives: To assess the relative contributions of maternal and fetal factors to perinatal mortality in twins.


Materials and Methods: Data was extracted from the birth register of a Nigerian tertiary health institution to identify maternal and fetal factors associated with a higher risk of perinatal mortality.


Outcome Measures: Perinatal deaths among twin pairs (ranked).


Results: The twinning rate was 32.3/1000(3.2%). Risk of perinatal death had linear correlation with birth asphyxia (r = 0.412, p < 0.01), birth weight of the second twin (r = 0.358, p < 0.01), birth weight of the smaller twin (r = -0.344, p < 0.01), presence of birth weight discordance (r = 0.278, p < 0.01), gestational age at delivery (r = -0.211, p < 0.05), birth weights of first and larger twins (r = -0.275, p < 0.01) and (r = -0.206, p < 0.05) respectively. The maternal age and parity showed no significant correlation with risk of perinatal death.


Conclusion: Birth asphyxia was the greatest predictor of perinatal death in twins among the variables studied.


Key Words: Twins, Birthweight Discordance, Perinatal Mortality


[Trop J Obstet Gynaecol, 2002, 19: 36-38].