Perinatal Mortality Among Twins In Lagos University Teaching Hospital : Associated Risk Factors
AbstractBackground: Perinatal mortality rate is reported to be higher in twins than in singletons. More than two decades ago, Abudu and Agarin reported a twinning rate of 21.1/1000 maternities and perinatal mortality rate of 142.6/1000 among twins in Lagos.
Objective: To determine the current perinatal mortality rate and risk factors that influence perinatal mortality among twins in Lagos University Teaching Hospital, Nigeria.
Materials and Methods: Babies weighing >1000grammes delivered by twin pregnancy between January 1996 and December 2000 in Lagos University Teaching Hospital were retrospectively studied. Routinely collected data from nurses and doctors registers in the departments of Obstetrics and Paediatrics on all twin deliveries was analysed.
Results: Out of 5,947 deliveries, there were158 set of twins' giving a twinning rate of 26.6/1000 for the institution. Fifteen of the babies weighed <1000g and so were excluded leaving 301 babies. Twenty-seven babies weighing >1000g died perinatally giving a perinatal mortality rate of 89.7/1000.
The significant risk factors for perinatal mortality identified in twins were lack of antenatal care (P=0.005), low gestational age and premature delivery (P<0.005), low birth weight especially <2000g (<0.001), like-sex pair (P=0.01) and breech presentation (P=0.05).
Conclusion: All multiple pregnancies should be supervised in institutions with facilities for premature care and babies who weigh <2000g, belong to like-sex pair or have breech presentation should be specially cared for by personnel trained in neonatal care because of a significant risk of perinatal mortality.
Nig. Qt. J. Hosp. Med. Vol.12(1-4) 2002: 21-25