Mortality among twins and singletons in sub-Saharan Africa between 1995 and 2014: a pooled analysis of data from 90 Demographic and Health Surveys in 30 countries

Monden, Christiaan; Smits, Jeroen

doi:10.1016/s2214-109x(17)30197-3

Cited by 61 publications

(70 citation statements)

References 30 publications

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“…This complies with the usual better survival outcome of the females as reports several manuscripts such as [34] or [35]. Multiple babies survive better than singleton babies; this is however against the results from studies conducted in Sub-Saharan Africa by Monden and Smits [36] and Pongou et al [37]. This may be due to the small number of multiple newborns recorded at KUTH along the year 2016.…”

Section: Discussionsupporting

confidence: 86%

Comparison of three classes of Marginal Risk Set Model in predicting infant mortality among newborn babies at Kigali University Teaching Hospital, Rwanda, 2016

Gatabazi¹,

Melesse²,

Ramroop³

2020

BMC Pediatr

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Background: The Infant Mortality Rate (IMR) in Sub-Saharan Africa (SSA) remains the highest relatively to the rest of the world. In the past decade, the policy on reducing infant mortality in SSA was reinforced and both infant mortality and parental death decreased critically for some countries of SSA. The analysis of risk to death or attracting chronic disease may be done for helping medical practitioners and decision makers and for better preventing the infant mortality. Methods: This study uses popular statistical methods of re-sampling and one selected model of multiple events analysis for measuring the survival outcomes for the infants born in 2016 at Kigali University Teaching Hospital (KUTH) in Rwanda, a country of SSA, amidst maternal and child's socio-economic and clinical covariates. Dataset comprises the newborns with correct information on the covariates of interest. The Bootstrap Marginal Risk Set Model (BMRSM) and Jackknife Marginal Risk Set Model (JMRSM) for the available maternal and child's socioeconomic and clinical covariates were conducted and then compared to the outcome with Marginal Risk Set Model (MRSM). That was for measuring stability of the MRSM. Results: The 2117 newborns had the correct information on all the covariates, 82 babies died along the study time, 69 stillborn babies were observed while 1966 were censored. Both BMRSM JMRSM and MRSM displayed the close results for significant covariates. The BMRSM displayed in some instance, relatively higher standard errors for nonsignificant covariates and this emphasized their insignificance in MRSM. The models revealed that female babies survive better than male babies. The risk is higher for babies whose parents are under 20 years old parents as compared to other parents' age groups, the risk decreases as the APGAR increases, is lower for underweight babies than babies with normal weight and overweight and is lower for babies with normal circumference of head as compared to those with relatively small head. Conclusion: The results of JMRSM were closer to MRSM than that of BMRSM. Newborns of mothers aged less than 20 years were at relatively higher risk of dying than those who their mothers were aged 20 years and above. Being abnormal in weight and head increased the risk of infant mortality. Avoidance of teenage pregnancy and provision of clinical care including an adequate dietary intake during pregnancy would reduce the IMR in Kigali.

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Section: Discussionsupporting

confidence: 86%

Comparison of three classes of Marginal Risk Set Model in predicting infant mortality among newborn babies at Kigali University Teaching Hospital, Rwanda, 2016

Gatabazi¹,

Melesse²,

Ramroop³

2020

BMC Pediatr

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“…We adopted the MI command for multiple imputations for observations with missing value on 1 or more factors of interest. 39,40 All statistical tests were 2-tailed, and P < .05 was considered statistically significant.…”

Section: Discussionmentioning

confidence: 99%

Factors Associated With Child Stunting, Wasting, and Underweight in 35 Low- and Middle-Income Countries

Kim

Vollmer³

et al. 2020

JAMA Netw Open

184

178

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IMPORTANCE Evidence on the relative importance of various factors associated with child anthropometric failures (ie, stunting, underweight, and wasting) and their heterogeneity across countries can inform global and national health agendas. OBJECTIVE To assess the relative significance of factors associated with child anthropometric failures in 35 low-and middle-income countries (LMICs). DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study of 299 353 children who were born singleton and aged 12 to 59 months with nonpregnant mothers and valid anthropometric measures assessed the strengths of associations of 26 factors with child stunting, underweight, and wasting, using Demographic and Health Surveys (2007-2018) from 35 LMICs. Data analysis was conducted from July 2019 to February 2020. EXPOSURES A total of 9 direct factors (ie, dietary diversity score; breastfeeding initiation; vitamin A supplements; use of iodized salt; infectious disease in past 2 weeks; oral rehydration therapy for children with diarrhea; care seeking for suspected pneumonia; full vaccination; and indoor pollution) and 17 indirect factors (household wealth; maternal and paternal education; maternal and paternal height and body mass index; maternal autonomy for health care, movement, and money; water source; sanitation facility; stool disposal; antenatal care; skilled birth attendant at delivery; family planning needs; and maternal marriage age) were assessed. MAIN OUTCOMES AND MEASURES Three anthropometric failure outcomes were constructed based on the 2006 World Health Organization child growth standards: stunting (height-forage z score less than −2 standard deviations [SDs]), underweight (weight-forage z score less than −2 SDs), and wasting (weight-for-height z score less than −2 SDs). RESULTS Among the 299 353 children aged 12 to 59 months included in the analysis, 38.8% (95% CI, 38.6%-38.9%) had stunting, 27.5% (95% CI, 27.3%-27.6%) had underweight, and 12.9% (95% CI, 12.8%-13.0%) had wasting. In the pooled sample, short maternal height was the strongest factor associated with child stunting (odds ratio [OR], 4.7; 95% CI, 4.5-5.0; P < .001), followed by lack of

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“…However, perinatal mortality and morbidity like congenital malformations in twin is 5-7 times higher as compared to singleton pregnancy(8)(9) (10). Second twin is found to be more vulnerable to adverse perinatal outcomes due to delivery complications(8)(11) which is attributed to fetal distress from decreased placental perfusion due to premature separation of the placenta, birth trauma from intrauterine manipulations, increased operative interventions due to mal-presentations(12)(13) and to di culties in fetal monitoring and the possibility of traumatic delivery following vaginal birth of the rst twin.…”

Section: Introductionmentioning

confidence: 99%

Short term perinatal outcome and their correlates among retained second twins, 15 years' retrospective study from northern Tanzania

Masoli

Maro

Masenga

et al. 2020

Preprint

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Background : Second twin delivery has been associated with poor perinatal outcome such as birth asphyxia ,neonatal ICU admission and perinatal death in comparison to the first twin. There is limited information on the perinatal outcome of second twin in Tanzania. This study aimed at determining the perinatal outcome associated with second twin delivery in a tertiary hospital in Northern Tanzania.Methods: A retrospective cross-sectional study was conducted in a Tanzanian northern zone tertiary health facility using existing maternal linked data from medical birth registry. Women with twin deliveries from 2000 to 2015 were recruited. Adverse perinatal outcomes associated with second twin deliveries were estimated using multivariable logistic regression models. A p-value of < 0.05 was considered statistically significant. Results : Retention rate of second twin was 18.6% (n=265). Out of the 265 retained second twins, 54.7% were referral cases, majority of which came from district hospitals. Retained second twins had 1.54 ( 95% CI 1.08-2.20) and 2.49( 95% CI 1.14-5.48) higher odds of lower Apgar scores in the 5 th minute and perinatal death when compared to non-retained twins respectively. Referral cases had poor outcome compared to non-referrals. Retained twin who had caesarean section had lower odds of low Apgar scores in the 5 th minute, perinatal death and Neonatal intensive care admission although this was not statistically significant but clinically significant. Conclusion : Rate of retained second twin is high in this setting, most of which are referral cases. The retained second twin is associated with higher risk for perinatal death and low Apgar score in the 5 th minute. Timely delivery by caesarean section has lower chances of perinatal death, Neonatal intensive care admission and low Apgar scores. Therefore, early diagnosis and/or referral of twin pregnancy coupled with timely and appropriate intervention for delivery of the retained second twin will contribute to reduction in perinatal morbidity and mortality.

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Mortality among twins and singletons in sub-Saharan Africa between 1995 and 2014: a pooled analysis of data from 90 Demographic and Health Surveys in 30 countries

Cited by 61 publications

References 30 publications

Comparison of three classes of Marginal Risk Set Model in predicting infant mortality among newborn babies at Kigali University Teaching Hospital, Rwanda, 2016

Comparison of three classes of Marginal Risk Set Model in predicting infant mortality among newborn babies at Kigali University Teaching Hospital, Rwanda, 2016

Factors Associated With Child Stunting, Wasting, and Underweight in 35 Low- and Middle-Income Countries

Short term perinatal outcome and their correlates among retained second twins, 15 years' retrospective study from northern Tanzania

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