Cerebral palsy in twins and multiple births at Sindhudurg Arabian west coast of Maharashtra (Large cohort analysis of 206124 births from 1996 to 2014)

Abstract

Introduction: This study aims at the prevalence of cerebral palsy in multiple births and also to determine the effects of birth weight and gestational age on the risk of cerebral palsy in a defined and contemporary Sindhudurg population. Material and Methods: Children born in 38 primary health centers, seven rural hospitals, three sub district hospitals and one civil hospital of this district between 1996 to 2014, inclusive comprised the cohort 2090 multiple birth deliveries with 4152 live births. Total number of deliveries from 1996 to 2014 was 2,06,124 observed in Sindhudurg district. Results: A moderate or severe congenital cerebral palsy had in 41 twins and three triplets, a prevalence of 10.8 and 13.6 per thousand twin and triplet children (95% CI 42, 9.8). The crude rate per 1000 survivors is 11.4 in multiple births. The cerebral palsy prevalence in male twins was three times more than female twins (RR =3.6, 95% CI 2.1, 6.2) and was higher in each birth weight group (below 1400 grams & 1500 to 2000 grams). The twins born with birth weight less than 1600 grams had prevalence of 58 per thousand (95% CI 42, 106),risk three times higher than that of singletons in the same birth weight group (RR = 1.2, 95% CI 0.6,1.8). Multiple logistic regression analysis confirmed the importance of twins and triplets as a risk factor for cerebral palsy with regard to weight and gestational age. Conclusion: Twin pregnancies and triplets produced 12 and 14 times more often cerebral palsy than singleton pregnancies.