Report: Twins Face an Increased Risk of Dying Before the Age of Five in Sub-Saharan Africa

A new report in a medical journal has revealed that one-fifth of all twins born in sub-Saharan Africa die before the age of 5 — a mortality rate that is three times higher than singletons.

The study, which was published in the Lancet using data collected from 30 sub-Saharan countries, shows that as many as 137 per 1,000 twins born in sub-Saharan Africa die before their first birthday.

According to the report, the death rate among single-born children aged under-five halved in the period between 1995 and 2014 but for twins, the rate came down only by a third.

The report concedes that although twin pregnancies anywhere in the world pose a relatively higher risk of complications for mother and child, in sub-Saharan Africa -a region with the highest rate of child mortality in the world- twins face an even greater risk of death within the first five years of their lives as compared to single births.

Because of the peculiarity of their birth, twins are prone to complications including low birthweight and preterm delivery. In addition, their mothers face an increased risk of severe blood loss, hypertensive disorders, and maternal mortality.

The authors of the study say it is the  first of its kind and express their surprise on the scant literature available on the subject, which has resulted in a knowledge gap. They describe twins as a “vulnerable group” and say coordinated action is required to improve their situation.

The report gave a few recommendations on improving the chances of survival for twins including improvements in the provision of health-care services needed during pregnancy, delivery, and postpartum.

According to the report, it is important that delivery of twins take place in a proper hospital setting with the full complement of trained staff with the necessary facilities to intervene in emergency situations like a caesarean section.

The study also called for the continuous monitoring of twins post-delivery and for the first few years of their lives. It noted that the mortality rates of twins remain high even after the perinatal period because in the first few years of their lives, twins stand an increased risk of suffering complications, such as delayed physical/mental growth amongst other birth defects.