Association of sociodemographic factors with multiple births and birth outcomes in comparison to single births among deliveries conducted at a tertiary hospital in Rewa, Madhya Pradesh

Abstract

Introduction: Multiple gestations are considered as high-risk pregnancy due to associated high maternal morbidity and perinatal mortality in comparison with singleton pregnancies. The present study was conducted to determine the frequency and outcomes of multiple births in comparison to single births and to study association of multiple births with sociodemographic variables. Methodology: A retrospective observational study was conducted at Gandhi Memorial Hospital, Rewa, Madhya Pradesh, India. Hospital medical records for the number of deliveries and subsequent details were looked into, for the year 2005. Information was collected on variables such as: sex at birth, birth outcome, and viability of the new-born at birth and birth weight, mode of delivery, residence, educational status, age, occupation and religion of the mother. Statistical analysis was performed using SPSS version 14.0 with all values expressed as percentages or mean and standard deviations. The association of sociodemographic characteristics of the mothers for single deliveries and multiple deliveries were compared using Chi-square test for the categorical variables. The outcome of single and multiple births for various variables were compared using unpaired t -test. A P ≤ 0.05 was considered to be statistically significant. Results: Overall prevalence of 29/1000 births was observed for multiple births out of the total 4170 deliveries for the year 2005. A higher proportion of multiple births (81%) were seen in mothers in the age group 20-29 years. Multiple births were found more at higher birth orders. Proportion of low birth weight (LBW) among multiple births was 29.8% and 19.3% in singleton births. Mean birth-weight was 2638.3 ± 430 g for single births and 2322.4 ± 446.7 g for multiple births. Cesarean mode of delivery was adopted in 14% of multiple births as compared with 11.4% in single births and assisted deliveries 8.3% in multiple births as compared with 3.2% in single births. Conclusion: Higher birth order along with young age of mother to be strongly implicated in the higher incidence of multiple births. Perhaps the outcome of multiple births resulted more LBW babies and accounted for the higher incidence of still births, cesarean and assisted deliveries as compared with single births. Timely detection of multiple births and highly equipped public-sector hospitals are the key to preventing complications and improving outcomes in such pregnancies.