A population-based cohort study of stillbirth among twins in Lusaka, Zambia.

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dc.contributor.affiliationDepartment of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
dc.contributor.affiliationDepartment of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Electronic address: elizabeth_stringer@med.unc.edu.
dc.contributor.affiliationDepartment of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.
dc.contributor.affiliationDepartment of Obstetrics and Gynaecology, University Teaching Hospital, Lusaka, Zambia.
dc.contributor.affiliationClinton Health Access Initiative, Boston, MA, USA.
dc.contributor.affiliationCentre for Infectious Disease Research in Zambia, Lusaka, Zambia.
dc.contributor.affiliationDepartment of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
dc.contributor.affiliationCIDRZ
dc.contributor.affiliationCentre for Infectious Disease Research in Zambia (CIDRZ)
dc.contributor.authorStringer EM
dc.contributor.authorChibwesha C
dc.contributor.authorStoner M
dc.contributor.authorVwalika B
dc.contributor.authorJoseph J
dc.contributor.authorChi BH
dc.contributor.authorKaunda E
dc.contributor.authorGoodnight W
dc.contributor.authorStringer JS
dc.date.accessioned2025-07-10T11:08:15Z
dc.date.issued2015-Jul
dc.description.abstractOBJECTIVE: To determine rates of stillbirth and the associated risk factors for stillbirth among twins delivered in Lusaka, Zambia. METHODS: A retrospective cohort analysis was conducted of singletons and twins delivered at 26 public sector facilities between February 1, 2006, and May 31, 2013. Data were obtained from the Zambian Electronic Perinatal Record System. Risk of stillbirth was estimated using logistic regression. RESULTS: Overall, 260 657 singletons and 4021 twin pairs were included. There were 5105 stillbirths; 317 twins were stillborn. The crude stillbirth rate for twins was 39.4 per 1000 births (95% confidence interval [CI] 35.2-43.7) whereas the rate for singletons was 18.4 per 1000 births (95% CI 17.9-18.9; P<0.001). Factors associated with stillbirth among twins were increased interval between delivery (>60 minutes), low birth weight (<2500 g), birth order (being the second-born), and difference in birth weights (>30% discordance). CONCLUSION: Twins were at an increased risk of stillbirth. Improved understanding of factors associated with stillbirth in this population could help to improve perinatal outcomes globally.
dc.identifier.doi10.1016/j.ijgo.2014.12.015
dc.identifier.urihttps://pubs.cidrz.org/handle/123456789/11270
dc.identifier.uri.pubmedhttps://pubmed.ncbi.nlm.nih.gov/25862294/
dc.sourceInternational journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
dc.titleA population-based cohort study of stillbirth among twins in Lusaka, Zambia.

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