Twinning and Its Correlates: Community-Based Study in a Rural Area of India

Abstract

A retrospective study was carried out to investigate the twinning rate and its correlates from January 1991 to December 2005 in 10 villages of the Rural Health Centre, Pohir, a field practice area of the Department of Community Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, India. During this study period, 5070 deliveries took place. A total of 5017 singleton births and 53 sets of twins were recorded, giving a twinning rate of 10.45 per 1000 total deliveries. Monozygotic and dizygotic twinning rates were estimated as 2.96 and 7.49 per 1000 deliveries, respectively. The twinning rate was strongly associated with maternal age; the twinning rate for mothers between 30 and 34 years of age was about 10 times higher than the rate for mothers younger than 20 years. This variation was due to variation in dizygotic twinning; the rate of monozygotic twinning was almost constant for all ages. The twinning rate was highest at gestational order 4 or higher. The perinatal mortality rate among the twins was 173.1 per 1000 total twin births and was significantly higher among the group in which diagnosis of twins was not done during the prenatal period. We should expect 1 twin birth per 100 births, and because perinatal mortality is alarmingly high in undiagnosed twin pregnancies, early recognition of twin pregnancy during prenatal visits and delivering in a health facility with adequately trained personnel should be encouraged.

Maternal determinants and fetal outcome of twin pregnancy: a five-year survey

“…[9][10][11]14 Literature supports the fact that complications are fewer in dichorionic than monochorionic twins. Dichorionicity being the majority contributes to the study having less fetal complications and better perinatal outcome.…”

“…16 A history of twins in the family was there in 40.4 % of patients in the present study. Yet only 10% association with family history was found in a study done by Satija et al 11 The inadvertent use of ovulation induction drugs and ART has contributed to the rise in higher order of gestation. Ovulation induction was done in 32% of patients in our study, out of which 3 were In-vitro fertilization pregnancies.…”

Outcome of Twin Pregnancy in a Periurban Hospital

“…Perinatal mortality was found to be higher among the group in which diagnosis of twin was not done during antenatal period indicating need for special preparation for conducting twin deliveries 12 .…”

“…It is said that twinning rate in hospital based studies may be higher than would be observed in the population since twins would be more likely to deliver at hospitals 5 . Twin rate in rural community of India and Thailand was reported to be 9.01 and 8.6 per 1000 delivery respectively 12,13 . In Denmark between 1980-94 the twinning rate was reported to be 12.1 per 1000 pregnancies and there was history of use of ovulation induction and advanced reproduction technique in about a quarter of multiple births 14 .…”

“…Study from Bangladesh and Nepal has shown a rate of 9 and 16.1 per 1000 pregnancies respectively 4,5 . Evidence from Bangladesh, rural India and Nepal shows that rates of twinning increase with increasing parity and it was highest among women 35 years and over 4,5,12 .…”