Twin Births and Their Survival under Age Five: Evidence from Bangladesh Demographic and Health Survey 2014
,
Abstract
Background & Aim: Little is known about twinning in developing countries due to lack of reliable data. However, the large data set from the national level Demographic and Health Surveys (DHSs) in developing countries can fill this gap. This paper examines the level, trends and determinants of twin births, and their risk of survival until age five relative to singletons in Bangladesh.
Methods & Materials: The data for the study were obtained from the 2014 Bangladesh DHS. The analysis was based on birth histories of 43,842 live births, experienced by the 17,863 women between 1978 and until survey date November 2014. Frequency distribution, cross tabulation, univariate and multivariate logistic regression models, and demographic methods such as conventional life table approach were used for data analysis.
Results: About 1.52% of the total live births in Bangladesh were found found to be twins. The twin birth rate has increased by 13.4% over the last 20 years in Bangladesh. Maternal age, parity, region of residence, economic status, father’s education, contraceptive use status and religion were identified as significant predictors of twin births. Twinning appeared as a significant predictor of high childhood mortality. Twins were found to have more than eight times higher risk of death during neonatal period than that of singletons.
Conclusion: The increasing trends in twin births in Bangladesh and the associated higher risk of childhood mortality among twins underscores the need for more focused care strategy during pregnancy and after birth. Further studies are needed to identify the reasons for exceptionally high childhood mortality among twins in Bangladesh
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4. Jena AB, Goldman DP & Joyce G. 2011. Association between the birth of twins and parental divorce. Obstetrics & Gynecology 2011;117(4): 892–897.
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7. Monden CWS, Smits JPJM. High infant and child mortality among twins in sub-Saharan Africa: Trends and explanations, in Annual Conference of the British Society for Population Studies, Winchester 2014.
8. Kim HM, Lee JW, Shin SH, Kim SK, Sung TJ. Comparison of neonatal outcomes between the spontaneous and in vitro fertilization twin pregnancies Korean J Pediatr 2007;50:740-5.
9. Loos RJ, Derom C, Derom R, Vlietinck R. Determinants of birthweight and intrauterine growth in liveborn twins. Paediatr Perinat Epidemiol 2005; 19 Suppl 2005;1:15-22.
10. Hoekstra C, Zhao ZZ, Lambalk CB, Willemsen G, Martin NG, Boomsma DI. & Montgomery GW. Dizygotic twinning. Human Reproduction Update 2008;14(1): 37–47.
11. Pison G, Monden C, & Smits J. Twinning Rates in Developed Countries: Trends and Explanations. Population and Development Review 2015;41(4): 629–649.
12. Martin JA, Hamilton BE, Osterman MJK, & National Center for Health Statistics. Three Decades of Twin Births in the United States, 1980–2009, US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics,2012.
13. Mutihir JE, Pam VC. Obstetric outcome of twin pregnancies in Jos, Nigeria: a 16 month review in Jos University Hospital, Nigeria. Niger J Clin Pract. 2007;10(1):15–18.
14. National Institute of Population Research and Training (NIPORT), Mitra and Associates, and ICF International. Bangladesh Demographic and Health Survey 2014. Dhaka, Bangladesh and Calverton, Maryland, USA: NIPORT, Mitra and Associates, and ICF International, 2016.
15. Rutstein SO, Johnson K. The DHS Wealth Index. Maryland: Calverton, 2004.
16. Alam N, Van Ginneken JK & Bosch AM. Infant mortality among twins and triplets in rural Bangladesh in 1975–2002. Tropical Medicine and International Health 2007;12:1506–1514.
17. Katz J, West KP Jr, Khatry SK, Le Clerq SC, Christian P, Pradhan EK, Shrestha SR. Twinning rates and survival of twins in rural Nepal. International Journal of Epidemiology 2001;30:802–807.
18. Sharma K. The twinning rates and epidemiological characteristics of births in southeast Uttar Pradesh, India. Acta Genet Med Gemellol (Roma) 1997;46(1):47-56.
19. Dodd J, Robinson J, Crowther C & Chan A. Stillbirth and neonatal outcomes in South Australia, 1991-2000. Am J Obstet Gynecol. 2003;189: 1731–1736.
20. Obiechina NJ, Okolie VE, Eleje GU, Okechukwu ZC & Anemeje OA. Twin versus singleton pregnancies: the incidence, pregnancy complications, and obstetric outcomes in a Nigerian tertiary hospital. International Journal of Women’s Health 2011;3:227–230.
21. Rothman KJ.Fetal loss, twinning and birth weight after oral-contraceptive use. N Engl J Med 1977;297:468–471.
22. Razzaque A, Ahmed K & Wai L. Twinning rates in a rural area of Bangladesh. Human Biology1990; 62:387–390.
23. Pollard R. Twinning rates in Fiji. Ann Hum Genet 1985;49:65-73.
24. Lilienfeld AM & Pasamanick B. A study of variations in the frequency of twin births by race and socio-economic status. Am J Hum Genet. 1955;7(2): 204–217.
25. Murphy MF, Campbell MJ, Bone M. Is there an increased risk of twinning after discontinuation of the oral contraceptive pill? J Epidemiol Community Health 1989;43:275–279.
26. Uthman OA, Uthman MB & Yahaya I. A population-based study of effect of multiple birth on infant mortality in Nigeria. BMC Pregnancy and Childbirth 2008;8:41-47.
27. Hong R. Effect of multiple birth on infant mortality in Bangladesh. J Paediatr Child Health 2006;42(10):630-635.
28. Kleinman JC, Fowler MG & Kessel SS. Comparison of infant mortality among twins and singletons: United States 1960 and 1983. American Journal of Epidemiology 1991;133:133–143.
29. Lawn JE, Cousens S & Zupan J. Four million neonatal deaths: When? Where? Why? Lancet 2005;365: 891–900.
30. Ministry of Health and Family Welfare, Bangladesh, Partnership for Maternal, Newborn & Child Health, WHO, World Bank and Alliance for Health Policy and Systems Research. 2015. Success Factors for Women’s and Children’s Health: Bangladesh. Available at http://www.who.int/pmnch/successfactors/en
31. Mercer A, Haseen F, Huq NL, Uddin N, Khan MH & Larson CP. Risk factors for neonatal mortality in rural areas of Bangladesh served by a large NGO programme. Health Policy Plan 2006;21:432-43.
32. Chowdhury HR, Thompson S, Ali M, Alam N, Yunus M & Streatfield PK. Causes of Neonatal Deaths in a Rural Subdistrict of Bangladesh: Implications for Intervention. J Health Ppoul Nutr 2010;28(4): 375-382.
33. Bryce J, Boschi-Pinto C, Shibuya, K & Black RE. WHO Child Health Epidemiology Reference Group. WHO estimates of the causes of death in children. Lancet 2005;365:1147-52.
34. Islam MM and Masud MS. Health care seeking behaviour during pregnancy, delivery and the postnatal period in Bangladesh: Assessing the compliance with WHO recommendations. Midwifery 2018 63: 8-16.
35. Yasmin S, Osrin D, Paul E, Costello A. Neonatal mortality of low-birth-weight infants in Bangladesh. Bull World Health Organ 2001;79:608-14.
36. Bangladesh Bureau of Statistics (BBS) and UNICEF. National Low Birth Weight Survey of Bangladesh, 2003-2004. Planning Division, Ministry of Planning, Government of People’s Republic of Bangladesh, Dhaka, 2005.
37. United Nations Children’s Fund (UNICEF) and World Health Organization (WHO). Low
Birth weight: Country, regional and global estimates. UNICEF, New York, 2004
38. Joseph KS, Marcoux S, Ohlsson A, Kramer MS, Allen AC, Liu S, Wu Wen S, Demissie K, Sauve R, Liston R. Preterm birth, stillbirth and infant mortality among triplet births in Canada, 1985-96. Paediatr Perinat Epidemiol 2002;16:141-48. 39. McCormick, M. The contribution of low birth weight to infant mortality and childhood morbidity. New England Journal of Medicine 1985;312(2): 82–90.
40. Kramer M. Determinants of low birth weight: methodological assessment and meta-analysis. Bulletin of the World Health Organization 1987;65(5): 663–737.
41. Kliegman RM, Rottman CJ & Behrman, RE. Strategies for the prevention of low birth weight. American journal of Obstetrics and Gynecology 1990;162(4):1073–1083.
42. Bang AT, Bang RA, Baitule SB, Reddy HM & Deshmukh MD. Management of birth asphyxia in home deliveries in rural Gadchiroli: the effect of two types of birth attendants and of resuscitating with mouth-to-mouth, tube-mask or bag-mask. J Perinatol 2005;25(Suppl):S82-91.
2. Smits J, Monden C. Twinning across the developing world. PLoS One 2011; 6: e25239.
3. Choi Y, Bishai D, Minkovitz CS. Multiple births are a risk factor for postpartum maternal depressive symptoms. Pediatrics 2009;123(4):1147–1154.
4. Jena AB, Goldman DP & Joyce G. 2011. Association between the birth of twins and parental divorce. Obstetrics & Gynecology 2011;117(4): 892–897.
5. Rauh-Hain JA, Rana S, Tamez H, Wang A, Cohen B, Cohen A, Brown F et al. Risk for developing gestational diabetes in women with twin Pregnancies. Journal of Maternal-Fetal and Neonatal Medicine 2009;22(4): 293–299.
6. Fresson J, Ego A, Rey S, Mouquet MC, Jay N, Blondel B. Analyse de la mortinatalité par le Programme de médicalisation du système d’information (PMSI): Premiers résultats nationaux. Revue d’épidémiologie et de santé publique 2015;63: S8–S9.
7. Monden CWS, Smits JPJM. High infant and child mortality among twins in sub-Saharan Africa: Trends and explanations, in Annual Conference of the British Society for Population Studies, Winchester 2014.
8. Kim HM, Lee JW, Shin SH, Kim SK, Sung TJ. Comparison of neonatal outcomes between the spontaneous and in vitro fertilization twin pregnancies Korean J Pediatr 2007;50:740-5.
9. Loos RJ, Derom C, Derom R, Vlietinck R. Determinants of birthweight and intrauterine growth in liveborn twins. Paediatr Perinat Epidemiol 2005; 19 Suppl 2005;1:15-22.
10. Hoekstra C, Zhao ZZ, Lambalk CB, Willemsen G, Martin NG, Boomsma DI. & Montgomery GW. Dizygotic twinning. Human Reproduction Update 2008;14(1): 37–47.
11. Pison G, Monden C, & Smits J. Twinning Rates in Developed Countries: Trends and Explanations. Population and Development Review 2015;41(4): 629–649.
12. Martin JA, Hamilton BE, Osterman MJK, & National Center for Health Statistics. Three Decades of Twin Births in the United States, 1980–2009, US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics,2012.
13. Mutihir JE, Pam VC. Obstetric outcome of twin pregnancies in Jos, Nigeria: a 16 month review in Jos University Hospital, Nigeria. Niger J Clin Pract. 2007;10(1):15–18.
14. National Institute of Population Research and Training (NIPORT), Mitra and Associates, and ICF International. Bangladesh Demographic and Health Survey 2014. Dhaka, Bangladesh and Calverton, Maryland, USA: NIPORT, Mitra and Associates, and ICF International, 2016.
15. Rutstein SO, Johnson K. The DHS Wealth Index. Maryland: Calverton, 2004.
16. Alam N, Van Ginneken JK & Bosch AM. Infant mortality among twins and triplets in rural Bangladesh in 1975–2002. Tropical Medicine and International Health 2007;12:1506–1514.
17. Katz J, West KP Jr, Khatry SK, Le Clerq SC, Christian P, Pradhan EK, Shrestha SR. Twinning rates and survival of twins in rural Nepal. International Journal of Epidemiology 2001;30:802–807.
18. Sharma K. The twinning rates and epidemiological characteristics of births in southeast Uttar Pradesh, India. Acta Genet Med Gemellol (Roma) 1997;46(1):47-56.
19. Dodd J, Robinson J, Crowther C & Chan A. Stillbirth and neonatal outcomes in South Australia, 1991-2000. Am J Obstet Gynecol. 2003;189: 1731–1736.
20. Obiechina NJ, Okolie VE, Eleje GU, Okechukwu ZC & Anemeje OA. Twin versus singleton pregnancies: the incidence, pregnancy complications, and obstetric outcomes in a Nigerian tertiary hospital. International Journal of Women’s Health 2011;3:227–230.
21. Rothman KJ.Fetal loss, twinning and birth weight after oral-contraceptive use. N Engl J Med 1977;297:468–471.
22. Razzaque A, Ahmed K & Wai L. Twinning rates in a rural area of Bangladesh. Human Biology1990; 62:387–390.
23. Pollard R. Twinning rates in Fiji. Ann Hum Genet 1985;49:65-73.
24. Lilienfeld AM & Pasamanick B. A study of variations in the frequency of twin births by race and socio-economic status. Am J Hum Genet. 1955;7(2): 204–217.
25. Murphy MF, Campbell MJ, Bone M. Is there an increased risk of twinning after discontinuation of the oral contraceptive pill? J Epidemiol Community Health 1989;43:275–279.
26. Uthman OA, Uthman MB & Yahaya I. A population-based study of effect of multiple birth on infant mortality in Nigeria. BMC Pregnancy and Childbirth 2008;8:41-47.
27. Hong R. Effect of multiple birth on infant mortality in Bangladesh. J Paediatr Child Health 2006;42(10):630-635.
28. Kleinman JC, Fowler MG & Kessel SS. Comparison of infant mortality among twins and singletons: United States 1960 and 1983. American Journal of Epidemiology 1991;133:133–143.
29. Lawn JE, Cousens S & Zupan J. Four million neonatal deaths: When? Where? Why? Lancet 2005;365: 891–900.
30. Ministry of Health and Family Welfare, Bangladesh, Partnership for Maternal, Newborn & Child Health, WHO, World Bank and Alliance for Health Policy and Systems Research. 2015. Success Factors for Women’s and Children’s Health: Bangladesh. Available at http://www.who.int/pmnch/successfactors/en
31. Mercer A, Haseen F, Huq NL, Uddin N, Khan MH & Larson CP. Risk factors for neonatal mortality in rural areas of Bangladesh served by a large NGO programme. Health Policy Plan 2006;21:432-43.
32. Chowdhury HR, Thompson S, Ali M, Alam N, Yunus M & Streatfield PK. Causes of Neonatal Deaths in a Rural Subdistrict of Bangladesh: Implications for Intervention. J Health Ppoul Nutr 2010;28(4): 375-382.
33. Bryce J, Boschi-Pinto C, Shibuya, K & Black RE. WHO Child Health Epidemiology Reference Group. WHO estimates of the causes of death in children. Lancet 2005;365:1147-52.
34. Islam MM and Masud MS. Health care seeking behaviour during pregnancy, delivery and the postnatal period in Bangladesh: Assessing the compliance with WHO recommendations. Midwifery 2018 63: 8-16.
35. Yasmin S, Osrin D, Paul E, Costello A. Neonatal mortality of low-birth-weight infants in Bangladesh. Bull World Health Organ 2001;79:608-14.
36. Bangladesh Bureau of Statistics (BBS) and UNICEF. National Low Birth Weight Survey of Bangladesh, 2003-2004. Planning Division, Ministry of Planning, Government of People’s Republic of Bangladesh, Dhaka, 2005.
37. United Nations Children’s Fund (UNICEF) and World Health Organization (WHO). Low
Birth weight: Country, regional and global estimates. UNICEF, New York, 2004
38. Joseph KS, Marcoux S, Ohlsson A, Kramer MS, Allen AC, Liu S, Wu Wen S, Demissie K, Sauve R, Liston R. Preterm birth, stillbirth and infant mortality among triplet births in Canada, 1985-96. Paediatr Perinat Epidemiol 2002;16:141-48. 39. McCormick, M. The contribution of low birth weight to infant mortality and childhood morbidity. New England Journal of Medicine 1985;312(2): 82–90.
40. Kramer M. Determinants of low birth weight: methodological assessment and meta-analysis. Bulletin of the World Health Organization 1987;65(5): 663–737.
41. Kliegman RM, Rottman CJ & Behrman, RE. Strategies for the prevention of low birth weight. American journal of Obstetrics and Gynecology 1990;162(4):1073–1083.
42. Bang AT, Bang RA, Baitule SB, Reddy HM & Deshmukh MD. Management of birth asphyxia in home deliveries in rural Gadchiroli: the effect of two types of birth attendants and of resuscitating with mouth-to-mouth, tube-mask or bag-mask. J Perinatol 2005;25(Suppl):S82-91.
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| Issue | Vol 5 No 2 (2019) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/jbe.v5i2.2346 | |
| Keywords | ||
| Twin births Survival Childhood Mortality Bangladesh | ||
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How to Cite
1.
Islam MM, Marium U. Twin Births and Their Survival under Age Five: Evidence from Bangladesh Demographic and Health Survey 2014. JBE. 2020;5(2):148-162.
