Bandim Health Project, INDEPTH Network, Apartado 861, 1004, Bissau Codex, Guinea-Bissau.
BMC Pregnancy Childbirth. 2012 Dec 5;12:140. doi: 10.1186/1471-2393-12-140.
Despite twinning being common in Africa, few prospective twin studies have been conducted. We studied twinning rate, perinatal mortality and the clinical characteristics of newborn twins in urban Guinea-Bissau.
The study was conducted at the Bandim Health Project (BHP), a health and demographic surveillance site in Bissau, the capital of Guinea-Bissau. The cohort included all newborn twins delivered at the National Hospital Simão Mendes and in the BHP study area during the period September 2009 to August 2011 as well as singleton controls from the BHP study area. Data regarding obstetric history and pregnancy were collected at the hospital. Live children were examined clinically. For a subset of twin pairs zygosity was established by using genetic markers.
Out of the 5262 births from mothers included in the BHP study area, 94 were twin births, i.e. a community twinning rate of 18/1000. The monozygotic rate was 3.4/1000. Perinatal mortality among twins vs. singletons was 218/1000 vs. 80/1000 (RR = 2.71, 95% CI: 1.93-3.80). Among the 13783 hospital births 388 were twin births (28/1000). The hospital perinatal twin mortality was 237/1000.Birth weight < 2000g (RR = 4.24, CI: 2.39-7.51) and caesarean section (RR = 1.78, CI: 1.06-2.99) were significant risk factors for perinatal twin mortality. Male sex (RR = 1.38, CI: 0.97-1.96), unawareness of twin pregnancy (RR = 1.64, CI: 0.97-2.78) and high blood pressure during pregnancy (RR = 1.77, CI: 0.88-3.57) were borderline non-significant. Sixty-five percent (245/375) of the mothers who delivered at the hospital were unaware of their twin pregnancy.
Twins had a very high perinatal mortality, three-fold higher than singletons. A birth weight < 2000g was the strongest risk factor for perinatal death, and unrecognized twin pregnancy was common. Urgent interventions are needed to lower perinatal twin mortality in Guinea-Bissau.
尽管双胞胎在非洲很常见，但很少有前瞻性双胞胎研究。我们研究了城市几内亚比绍的双胞胎出生率、围产期死亡率和新生儿双胞胎的临床特征。
该研究在班迪姆健康项目（BHP）进行，BHP 是几内亚比绍首都比绍的一个健康和人口监测点。该队列包括 2009 年 9 月至 2011 年 8 月期间在国家西蒙·门德斯医院分娩的所有双胞胎新生儿以及 BHP 研究区的单胎对照，以及 BHP 研究区的单胎对照。在医院收集有关产科史和妊娠的数据。对存活的儿童进行临床检查。对于双胞胎的一部分，通过遗传标记确定了同卵性。
在包括在 BHP 研究区的 5262 名母亲中，有 94 名是双胞胎分娩，即社区双胞胎出生率为 18/1000。同卵双胞胎率为 3.4/1000。双胞胎与单胎的围产期死亡率分别为 218/1000 和 80/1000（RR=2.71，95%CI：1.93-3.80）。在 13783 例医院分娩中，有 388 例是双胞胎分娩（28/1000）。医院围产期双胞胎死亡率为 237/1000。出生体重<2000g（RR=4.24，CI：2.39-7.51）和剖宫产（RR=1.78，CI：1.06-2.99）是围产期双胞胎死亡的显著危险因素。男性（RR=1.38，CI：0.97-1.96）、不知道双胞胎妊娠（RR=1.64，CI：0.97-2.78）和妊娠高血压（RR=1.77，CI：0.88-3.57）是边缘非显著性的。65%（245/375）在医院分娩的母亲不知道自己怀的是双胞胎。
双胞胎的围产期死亡率非常高，是单胎的三倍。出生体重<2000g 是围产期死亡的最强危险因素，未识别的双胞胎妊娠很常见。急需采取干预措施降低几内亚比绍的围产期双胞胎死亡率。
