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. 2019 Jan 16;14(1):e0209962.
doi: 10.1371/journal.pone.0209962. eCollection 2019.

Temporal trends in the birth rates and perinatal mortality of twins: A population-based study in China

Changfei Deng  1   2   3 , Li Dai  1   4 , Ling Yi  1 , Xiaohong Li  1 , Kui Deng  1 , Yi Mu  1 , Ke Wang  1 , Jing Tao  1 , Qi Li  1 , Liangzhi Xu  2   3
Affiliations

Temporal trends in the birth rates and perinatal mortality of twins: A population-based study in China

Changfei Deng et al. PLoS One. .

Abstract

Objective: Until now, little was known about the epidemiological characteristics of twins in China due to a lack of reliable national data. In this study, we aimed to analyze temporal trends and perinatal mortality of twins from China.

Methods: Data on twins between 2007 and 2014 were obtained from the China National Population-Based Birth Defects Surveillance System. Twin and singleton deliveries after at least 28 weeks of gestation were recruited and followed until postnatal day 42. Twinning rates were defined as the number of twin individuals per 1000 births(stillbirths and live births). The Weinberg's differential method was utilized to estimate the number of monozygotic and dizygotic twins.

Results: During 2007-2014, the twinning rate increased by 32.3% from 16.4 to 21.7 per 1000 total births with an average of 18.8‰. Among twins, both the perinatal mortality rate (26.1 per 1000 total births) and neonatal death rate (15.7 per 1000 live births) presented a downward tendency but remained at a high level. Large urban-rural and geographic disparities were identified in twinning rates, in perinatal and neonatal mortality, and in their temporal trends.

Conclusions: The upward trend of twinning rates in China paired with the relatively high rates of perinatal and neonatal mortality among twins highlights the need for improved perinatal care in the light of socio-demographic differences.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Time trends in twinning rates according to socio-demographic and infant characteristics in China, 2007–2014.
Stratified by: a) urban-rural classification, b) geographic region, c) maternal ethnicity, d) maternal residence registration, e) maternal age, and f) parity.
Fig 2
Fig 2. Time trends in stillbirth rate and the perinatal, early neonatal and neonatal mortality rates in Chinese twins.
SBR, PMR, ENDR and NNDR represent stillbirth rate, perinatal mortality rate, early neonatal death rate and neonatal death rate, respectively. a. SBR and PMR by birth area; b. ENDR and NNDR by birth area; c. SBR and PMR by geographic region; d. ENDR and NNDR by geographic region.
See this image and copyright information in PMC

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