Twin Mortality in a Tertiary Hospital in Central Nigeria

Background: The risk of perinatal death in twin pregnancies is increased 2-5 times compared to singletons, and the identification of preventable risk factors becomes increasingly important as the number of multiple pregnancies increases. The objectives of this study were to determine the perinatal mortality rate, the factors that influence perinatal death, andpossible causes of death among twins.Methodology: Twin gestations from 28 weeks or more delivered between 1st January 2000 and 31st December 2007 in Jos University Teaching Hospital (JUTH) were retrospectively studied.Results: Of the 20,612 deliveries within the period, there were 808 sets of twins, giving a twining rate of 30/1,000 deliveries in the institution. The perinatal mortality rate was 80 per 1000 twin deliveries. The major risk factors identified for perinatal mortality in twins were preterm delivery (90.3%), very low birth weight (35.6%) for 1st twin (twin A) and (43.9%) for 2nd twin (twin B), extremely low birth weight (35.6%) for twin Aand 35.1% for twin B. The most probable cause of death was prematurity and its complications, which accounted for 56.1% deaths in twin B and 62.2% deaths in twin A.Conclusion: Perinatal mortality rate among twins in JUTH is high, with preterm delivery as a major risk factor and prematurity as the most probable cause of perinatal mortality