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Perinatal and infant mortality in twins
Insights
Twin infants face significantly higher perinatal and infant mortality rates compared to singletons. The B twin is at greater risk, particularly with premature birth or low birth weight, highlighting critical areas for intervention.
Area of Science:
- Obstetrics and Gynecology
- Neonatalogy
- Public Health
Background:
- High rates of perinatal and infant mortality pose a significant public health challenge.
- Twin gestations are known to carry increased risks compared to singleton pregnancies.
- Understanding mortality patterns in twins is crucial for improving neonatal outcomes.
Purpose of the Study:
- To investigate and compare perinatal and infant mortality rates between twins and singletons.
- To identify specific risk factors contributing to mortality in twin births.
- To analyze the mortality differences between A and B twins.
Main Methods:
- Retrospective cohort study analyzing birth data from 1970-1976.
- Inclusion of all births in the South Moravian Region, Czechoslovakia.
- Statistical comparison of mortality rates between twin and singleton infants.
Main Results:
- Total births: 237,655 (4,072 twins).
- Twins exhibited 11x higher perinatal and 6x higher infant mortality than singletons.
- Mortality was significantly higher for B twins, especially those with birthweights of 1,000-2,499 gm and gestational age of 22-36 weeks.
Conclusions:
- Prematurity and anoxia/hypoxia are primary causes of twin mortality.
- The B twin faces elevated mortality risk, though A twins also have higher risk than singletons (except for low birthweight infants).
- Targeted interventions for premature and anoxic twins are essential to reduce mortality.
Abstract:
The perinatal and infant mortality in the sample of all children born in the South Moravian Region of Czechoslovakia in the years 1970--1976 was studied. The total number of births was 237,655, including 4,072 twin children. The perinatal mortality of twins was 11 times higher and the infant mortality of twins was six times higher than those of the singletons. The mortality of B twins was significantly higher, especially in the groups with birthweight of 1,000 to 2,499 gm and with a gestational age of 22--36 weeks. The most important causes of deaths in twins are prematurity and anoxia or hypoxia. The B twin is more at risk, but also for the A twin the risk is higher for the average singleton. This difference disappears when only the infants with low birthweights are compared.