Abstract
BackgroundMulti-foetal pregnancies and multiple births including twins and higher order multiples births such as triplets and quadruplets are high-risk pregnancy and birth. These high-risk groups contribute to the higher rate of childhood mortality especially during early period of life.MethodsWe examined the relationship between multiple births and infant mortality using univariable and multivariable survival regression procedure with Weibull hazard function, controlling for child's sex, birth order, prenatal care, delivery assistance; mother's age at child birth, nutritional status, education level; household living conditions and several other risk factors.ResultsChildren born multiple births were more than twice as likely to die during infancy as infants born singleton (hazard ratio = 2.19; 95% confidence interval: 1.50, 3.19) holding other factors constant. Maternal education and household asset index were associated with lower risk of infant mortality.ConclusionMultiple births are strongly negatively associated with infant survival in Nigeria independent of other risk factors. Mother's education played a protective role against infant death. This evidence suggests that improving maternal education may be key to improving child survival in Nigeria. A well-educated mother has a better chance of satisfying important factors that can improve infant survival: the quality of infant feeding, general care, household sanitation, and adequate use of preventive and curative health services.
Highlights
Multi-foetal pregnancies and multiple births including twins and higher order multiples births such as triplets and quadruplets are high-risk pregnancy and birth
(page number not for citation purposes) http://www.biomedcentral.com/1471-2393/8/41 vey (NDHS) by multiple birth status and other selected characteristics are shown in Table 1
More than one-third (35%) of the births were in North West, 24% were in North East, 14% were in North Central, 13% were in South South, 9% were in South West, and only 6% were in South East
Summary
Multi-foetal pregnancies and multiple births including twins and higher order multiples births such as triplets and quadruplets are high-risk pregnancy and birth. Despite significant improvements in child survival in recent decades, levels of infant and child mortality and morbidity remain unacceptably high in many developing countries [1,2] These problems are serious among high-risk pregnancies and births, and in developing countries where the health-care system is still struggling to provide basic public health and maternal and child health care to their population[3,4]. In such countries, adequate health-care services for managing high-risk pregnancy and delivery are usually available at the referral levels such as regional and national hospitals[5,6]. The aim of this study was to examine if infants of multiple births have disproportionately higher risk of mortality than infants of singleton births
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