A Review of Twinning in Niger Delta Region, Nigeria

Abstract

Background: Twin pregnancy is as fascinating as it is high risk and its epidemiology is globally more dynamic in the recent times. It is associated with increase maternal morbidities, fetal wastage and neonatal morbidities and mortality. Objectives: To determine the current incidence, assess the trend and investigate maternal and perinatal outcomes and influencing factors of twinning. Methods: For this case control study, data was collected on twin pregnancies; the study group and singleton pregnancies; the control group between January 2009 and December 2016 at a missionary Hospital in southsouth Nigeria. EPI INFO and INSTAT statistical software were used for analyses and Fisher's exact test for tests of statistical associations setting the statistical significance at <.05. Results: Among 8769 deliveries were 207 pairs of twins, a twinning incidence of 2.4% or 1 in 42 with an upward trend in incidence. Twin mothers were relatively older with those aged 30-34 years (41.2%) as the modal age group, less literate and less likely to have prenatal care. They were more prone to anemia, caesarean birth, Postpartum hemorrhage, gestational hypertension and blood transfusion (P<0.05). Mean gestational age and birth weight of twins were 35.5±3.8 weeks and 2352.9±746.4gm respectively. The twins were associated with increased preterm births (OR 28.1, P<0.001), Low birth weight (OR 15.6-24.1, P<0.001), perinatal death (OR 3.6, P<0.001), birth asphyxia (OR 2.9-5.9, P<0.01) and Special Care Baby Unit admission (OR 9.8-12.5, P<0.001). About 7 (66.2%) and 3 (31.4%) of every 10 first twins were in cephalic and breech presentation respectively with cephalic/cephalic (44.0%) the leading paired presentations. Conclusion: There was high and increasing incidence of twinning in this population. Twin pregnancy is associated with increased maternal morbidity and perinatal morbidity and mortality. To improve twinning outcome will require quality obstetric and perinatal care.

Multiple gestation and perinatal outcome in the Federal Medical Centre, Yenagoa, South-South, Nigeria: A 5-year review

“…that was previously reported in an earlier study in Bayelsa State. However, it is similar to those of previous studies where the mean gestational age were 35.5 weeks [16]. in Benin city, 35.7 weeks [15].…”

“…in Bida, North-Central Nigeria and 19.5/ 1000 [15]. in Port Harcourt, 24/1000 [16]. in Edo, 25.9/1000 [17].…”

Prevalence, trend and outcome of twin pregnancy in Rivers State University Teaching Hospital, Southern Nigeria

“…This is in agreement with the findings of previous studies. 16,17 The high proportion of women in this study with formal education could account for this finding. Women with formal education, seems to have a higher chance of registering their pregnancies in a tertiary health facility for expert care compared to those without formal education.…”

“…This finding is comparable to those of previous studies 35.5 weeks and 36.2, though lower than 36.6 and 36.9 weeks reported in Ekiti and Kano states of Nigeria respectively. 11,12,16 However, the confidence interval presented in our study is helpful in interpretation of the finding. It shows that the true mean gestational age of the population lies between 35.3 and 36 weeks.…”

“…This finding corroborates that of a recent study in Niger Delta region of Nigeria. 16 However, there was a marked decline among women aged 40-44 years and above. This may be due to higher chances of increased fertility in younger age group compared to older group.…”