Twin Births and Their Survival under Age Five: Evidence from Bangladesh Demographic and Health Survey 2014

Abstract

Background & Aim: Little is known about twinning in developing countries due to lack of reliable data. However, the large data set from the national level Demographic and Health Surveys (DHSs) in developing countries can fill this gap. This paper examines the level, trends and determinants of twin births, and their risk of survival until age five relative to singletons in Bangladesh.

Methods & Materials: The data for the study were obtained from the 2014 Bangladesh DHS. The analysis was based on birth histories of 43,842 live births, experienced by the 17,863 women between 1978 and until survey date November 2014. Frequency distribution, cross tabulation, univariate and multivariate logistic regression models, and demographic methods such as conventional life table approach were used for data analysis.

Results: About 1.52% of the total live births in Bangladesh were found found to be twins. The twin birth rate has increased by 13.4% over the last 20 years in Bangladesh. Maternal age, parity, region of residence, economic status, father’s education, contraceptive use status and religion were identified as significant predictors of twin births. Twinning appeared as a significant predictor of high childhood mortality. Twins were found to have more than eight times higher risk of death during neonatal period than that of singletons.

Conclusion: The increasing trends in twin births in Bangladesh and the associated higher risk of childhood mortality among twins underscores the need for more focused care strategy during pregnancy and after birth. Further studies are needed to identify the reasons for exceptionally high childhood mortality among twins in Bangladesh.