Trends and Outcomes of Twin Births in Southwest Nigeria: A 14-Year Retrospective Cohort Study

Emeka Philip Igbodike; Omotade Adebimpe Ijarotimi; Akaninyene Eseme Ubom; George Uchenna Eleje; Chigbo Chisom God'swill; Boniface Chukwuneme Okpala; Nwaoma Leslie Nwaogu; Kayode Olusegun Ajenifuja; Joseph Ifeanyichukwu Ikechebelu; Olabisi Morebisi Loto; Uche Onwudiegwu; Ahizechukwu Chigoziem Eke

doi:10.14218/ERHM.2023.00039

Trends and Outcomes of Twin Births in Southwest Nigeria: A 14-Year Retrospective Cohort Study

Explor Res Hypothesis Med. 2024 Mar;9(1):15-24. doi: 10.14218/ERHM.2023.00039. Epub 2023 Nov 29.

Authors

Affiliations

¹ Department of Obstetrics, Gynaecology and Perinatology, Obafemi Awolowo University, Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria.
² Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital Nnewi, Anambra State, Nigeria.
³ Effective Care Research Unit, Department of Obstetrics and Gynecology, Nnamdi Azikiwe University, Awka, Nigeria.
⁴ NAUTH Research Society, Nnamdi Azikiwe University Teaching Hospital, Awka, Nigeria.
⁵ Mother and Child Hospital, Ikeja, Nigeria.
⁶ Division of Maternal Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Abstract

Background and objectives: The study aimed to analyze the prevalence, trends, and outcomes of twin pregnancies in Ile-Ife, Nigeria, over two distinct periods.

Materials and methods: This research, based on a 14-year retrospective cohort study, scrutinized twin births occurring in two-time frames: recent years (2012-2018; Period II) and the recent past (2005-2011; Period I) at a University Teaching Hospital in Ile-Ife, Nigeria. The inclusion criteria were limited to twin births, excluding singleton and higher-order gestations. Outcomes were evaluated based on several parameters, including mode of delivery, birth weights, fetal gender combinations, APGAR scores, perinatal mortality, and maternal complications. Data analysis was conducted using the 26^th version of Statistical Package for the Social Science, with a significance threshold of p < 0.05.

Results: The study documented a stable prevalence of twin gestations, registering at 20.7 per 1,000 births without a significant discrepancy between the two time periods (21.7‰ versus 19.7‰; p = 0.699). Individuals from the Yoruba tribe predominantly featured in both cohorts, showing no considerable variation between the two time periods [83 (95.4) vs. 120 (99.2); p-value = 0.116]). The data exhibited recurrent instances of caesarean delivery (65.6% vs. 50.2%, p = 0.119), vertex-vertex presentation (38.0% vs. 44.7%, p = 0.352), and differing sex combinations (33.3% vs. 38.0%, p = 0.722) across both time frames. Twin II neonates born through Caesarean section were more frequently admitted to neonatal intensive care units than Twin I (5.1% versus 4.6%; p = 0.001). The recent years witnessed a surge in preterm labor complications, notably higher than the earlier period (17.1% versus 7.8%; p = 0.008).

Conclusion: The prevalence of twin births in Ile-Ife, Nigeria, demonstrates a fluctuating decline. To comprehensively understand the dynamics of twin births in the region, there is a pressing need for expansive, community-centric research in southwest Nigeria.

Keywords: Ile-Ife; Multiple gestations; Perinatal outcomes; Prevalence; Retrospective cohort study; Southwest Nigeria; Twin births.

Grants and funding

K23 HD104517/HD/NICHD NIH HHS/United States