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Perinatal Outcomes of Multiple-Gestation Pregnancies in Kenya, Zambia, Pakistan, India, Guatemala, and Argentina: A Global Network Study
- Source :
- American Journal of Perinatology. 31:125-132
- Publication Year :
- 2013
- Publisher :
- Georg Thieme Verlag KG, 2013.
-
Abstract
- AIM: To determine the rates of multiple gestation stillbirth and perinatal and neonatal mortality and to determine health care system characteristics related to perinatal mortality of these pregnancies in low- and middle-income countries. METHODS: Pregnant women residing within defined geographic boundaries located in six countries were enrolled and followed to 42 days postpartum. RESULTS: Multiple gestations were 0.9% of births. Multiple gestations were more likely to deliver in a health care facility compared with singletons (70 and 66% respectively p < 0.001) to be attended by skilled health personnel (71 and 67% p < 0.001) and to be delivered by cesarean (18 versus 9% p < 0.001). Multiple-gestation fetuses had a relative risk (RR) for stillbirth of 2.65 (95% confidence interval [CI] 2.06 3.41) and for perinatal mortality rate (PMR) a RR of 3.98 (95% CI 3.40 4.65) relative to singletons (both p < 0.0001). Neither delivery in a health facility nor the cesarean delivery rate was associated with decreased PMR. Among multiple-gestation deliveries physician-attended delivery relative to delivery by other health providers was associated with a decreased risk of perinatal mortality. CONCLUSIONS: Multiple gestations contribute disproportionately to PMR in low-resource countries. Neither delivery in a health facility nor the cesarean delivery rate is associated with improved PMR. Thieme Medical Publishers 333 Seventh Avenue New York NY 10001 USA.
- Subjects :
- Adult
Male
Risk
Pediatrics
medicine.medical_specialty
Population
Global Health
Article
Multiple Gestation
Young Adult
Pregnancy
Infant Mortality
medicine
Global health
Humans
education
Developing Countries
Perinatal Mortality
education.field_of_study
Obstetrics
business.industry
Mortality rate
Infant, Newborn
Pregnancy Outcome
Obstetrics and Gynecology
Stillbirth
medicine.disease
Infant mortality
Relative risk
Pediatrics, Perinatology and Child Health
Pregnancy, Twin
Female
Multiple birth
Pregnancy, Multiple
business
Subjects
Details
- ISSN :
- 10988785 and 07351631
- Volume :
- 31
- Database :
- OpenAIRE
- Journal :
- American Journal of Perinatology
- Accession number :
- edsair.doi.dedup.....ca29be75b548d9b80d21bf5459558e46