Area of Science:

• Demography
• Public Health
• Maternal and Child Health

Background:

• Haiti experiences the highest twin birth rate in Latin America and the Caribbean, approximately 17%.
• High child mortality rates in Haiti are exacerbated by the additional burden of excess twin mortality.
• Studies on excess twin mortality in Haiti are limited, despite its public health significance.

Purpose of the Study:

• To identify key factors associated with the elevated mortality rates among twin births in Haiti.
• To analyze the trends and determinants of under-five mortality in twins compared to singletons.

Main Methods:

• Utilized data from the Demographic and Health Surveys to calculate under-five mortality rates (U5MR).
• Employed Cox regression analysis to investigate factors linked to excess mortality in twins.
• Compared mortality rates and risk factors between twin and singleton births.

Main Results:

• Twins exhibit under-five mortality rates three times higher than singletons.
• While U5MR decreased for both groups between 1994 and 2016, the reduction was more pronounced for twins (53%) than singletons (36%).
• Independent risk factors for excess twin mortality include low birth weight, absence of prenatal visits, and lack of breastfeeding.

Conclusions:

• The health of twin infants in Haiti remains a critical public health challenge.
• Developing accessible obstetric and pediatric services is crucial for reducing excess twin mortality.
• Targeted interventions addressing low birth weight, prenatal care, and breastfeeding are essential for improving twin survival rates.