Postneonatal and child mortality among twins in Southern and Eastern Africa

Justesen, Aafke; Kunst, Anton E.

doi:10.1093/ije/29.4.678

Cited by 46 publications

(67 citation statements)

References 16 publications

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“…Particularly vulnerable are twins born after a short birth interval, from poor families, with an older mother, or when one child of a twin pair has died. 5,6,17 If the care for twins and women pregnant with twins does not improve considerably in the coming years, the absolute numbers of twin deaths will hardly decrease. At the current speed of improved survival among twins, the reduction in the number of deaths will be compensated to a large extent by the growth in the under-5 population in the region, which is expected to increase by about 20% until 2030.…”

Section: Discussionmentioning

confidence: 99%

“…2-4 Under-5 and neonatal mortality rates are two to five times higher than among twins compared with the largest relative differences found in regions with the lowest mortality rates. [5][6][7][8][9][10] For example, in Finland, which has one of the lowest infant mortality rates in the world, infant mortality among multiple births is considerably higher than among singletons (11·1 vs 1·9 deaths per 1000 livebirths in the period 2010-15; Ahokas E, Population Statistics, Statistics Finland, personal communication). Twins suffer more from congenital malformations and could also therefore be more vulnerable after the first year of life.…”

Section: Introductionmentioning

confidence: 99%

“…15 High mortality rates among twins have been documented for many sub-Saharan sites or countries, with under-5 mortality rates ranging from over 200 to almost 400 deaths per 1000 livebirths. 5,6,16,17 Also, maternal mortality and morbidity associated with e674…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

Smits

2017

The Lancet Global Health

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

Smits

2017

The Lancet Global Health

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“…There also exist case reports [21][22][23][24], including triplets [25,26] and quadruplets [18,27], and detailed descriptions of breast-feeding multiples with relatively small sample sizes [2,15,25,28,29]. Some reports [30][31][32][33][34][35][36][37][38] deal with multiples in comparison with singletons or control groups, or treat multiple births as a risk factor.…”

Section: Introductionmentioning

confidence: 99%

Breast-feeding rates and related maternal and infants’ obstetric factors in Japanese twins

Ooki

2008

Environ Health Prev Med

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Objectives The aims of the present study are to describe the secular trend of breast-feeding rates in Japanese twins in comparison with the general population, and then to clarify the maternal and infants' obstetric factors associated with breast-feeding in twins. Methods Breast-feeding rates from 0 to 6 full months and related maternal and infant obstetric factors were analyzed using 4,023 Japanese twins, consisting of two different volunteer-based twin samples, age 1-15 years, whose birth year ranged from 1968 to 2003. Data were collected through mailed or hand-delivered questionnaires. Obstetric factors that affect full and partial breast-feeding of twins were confirmed using logistic analyses according to birth order in twin pairs, adjusted by birth year. Results The full breast-feeding rates of twins were lower than those of the general population. On the other hand, the combined rates of full and partial breast-feeding were close to those of general population, except for the period 1968-1974. The percentage of concordance pares was around 95% for all months. The most influential factor that negatively correlated with breast-feeding from 0 to 6 months was gestational weeks. Higher maternal age at twin birth and the use of an incubator also prevented breast-feeding in the neonatal period. Conclusions The results of the present study for the first time indicated that full breast-feeding of twins has risen recently in Japan, although the rates are still lower than those of the general population. The importance of the gestational weeks for breast-feeding rates was also shown.

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“…Multiple births increase the risk of both infant mortality and child mortality (Guo et al, 1993;Justesen and Kunst, 2000); thus a dummy for whether a child was a multiple is included in the regression. Male infants universally have higher mortality rates than female until about age 6 months due to greater biological weakness of male infants (Svedburg, 1990;Mahy, 2003).…”

Section: Other Characteristicsmentioning

confidence: 99%

Wealthiest Is Not Always Healthiest: What Explains Differences in Child Mortality in West Africa?

Ickowitz

2011

Journal of African Economies

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Abstract. Ghana has the lowest under-five mortality rate in West Africa. Understanding why Ghana's child mortality rate is lower than in neighboring countries may offer useful insights for other developing countries that are trying to improve child health. This paper explores whether Ghana's lower mortality rate is mostly a result of greater household wealth, better implementation of national health policies, or more favorable geography. The paper uses micro level data for children under five to examine relative child mortality risk between Ghana and each of its three immediate neighbors --Burkina Faso, Côte d'Ivoire, and Togo. A Cox proportional hazards model is used to test which of the three 'contenders' -health policy, wealth, or geography -best explains Ghana's mortality advantage. The results of the analysis indicate that wealth variables are not able to explain any of the child mortality variation between Ghana and its neighbors. Geography and health policy variables each explain about 40% of the mortality gap between Ghana and Burkina Faso. Health policy differences alone are able to explain about 70% of the child mortality gap between Ghana and Côte d'Ivoire. These results suggest that even poor countries that have been 'cursed' by bad geography can potentially improve development outcomes and save children's lives.

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Postneonatal and child mortality among twins in Southern and Eastern Africa

Cited by 46 publications

References 16 publications

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

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

Breast-feeding rates and related maternal and infants’ obstetric factors in Japanese twins

Wealthiest Is Not Always Healthiest: What Explains Differences in Child Mortality in West Africa?

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