ArticleBMJ open2021
Prevalence and outcomes of twin pregnancies in Botswana: a national birth outcomes surveillance study.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- Prevalence and adverse outcomes of twin pregnancy in Eastern Africa: a systematic review and meta-analysis.BMC pregnancy and childbirth · 2024Pooled it
- [Risk factors for bronchopulmonary dysplasia in twin preterm infants: a multicenter study].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2024Article
- The impact of free antiretroviral therapy for pregnant non-citizens and their infants in Botswana.Journal of the International AIDS Society · 2023Article
- Perinatal characteristics and neonatal outcomes of singletons and twins in Chinese very preterm infants: a cohort study.BMC pregnancy and childbirth · 2023Article
- Patterns of pregnancy loss among women living with and without HIV in Brazil, 2008-2018.AJOG global reports · 2022Article
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Authors and funding
11 authors at 4 institutions in 2 countries.
Funding
Abstract
objectivesThis study aims to evaluate the prevalence and outcome of twin pregnancies in Botswana.
settingThe Tsepamo Study conducted birth outcomes surveillance at 8 government-run hospitals (~45% of all births in Botswana) from August 2014 to June 2018 and expanded to 18 hospitals (~70% of all births in Botswana) from July 2018 to March 2019.
participantsData were collected for all live-born and stillborn in-hospital deliveries with a gestational age (GA) greater than 24 weeks. This analysis included 117 593 singleton and 3718 twin infants (1859 sets (1.6%)) born to 119 477 women between August 2014 and March 2019 and excluded 73 higher order multiples (23 sets of triplets and 1 set of quadruplets). OUTCOMES MEASURED: Our primary outcomes were preterm delivery (<37 weeks GA), very preterm delivery (<32 weeks GA) and stillbirth (APGAR (Appearance, Pulse, Grimace, Activity, Respiration) score of 0, 0, 0).
resultsWomen with twin pregnancies had a similar median number of antenatal care visits (9 vs 10), but were more likely to deliver in a tertiary centre (54.8% vs 45.1%, p<0.001) and more likely to have a cesarean-section (54.6% vs 22.0%, p<0.001) than women with singletons. Compared with singletons, twin pregnancies had a higher risk of preterm delivery (<37 weeks GA) (47.6% vs 16.7%, adjusted risk ratio (aRR) 2.8, 95% CI 2.7 to 2.9) and very preterm delivery (<32 weeks) (11.8% vs 4.0%, aRR 3.0 95% CI 2.6 to 3.4). Among all twin pregnancies, 128 (6.9%) had at least one stillborn infant compared with 2845 (2.4%) stillbirths among singletons (aRR 2.8, 95% CI 2.3 to 3.3).
conclusionAdverse birth outcomes are common among twins in Botswana, and are often severe. Interventions that allow for earlier identification of twin gestation and improved antenatal management of twin pregnancies may improve infant and child survival.
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