{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T15:35:09Z","timestamp":1790004909323,"version":"4.0.1"},"reference-count":25,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2010,12,31]],"date-time":"2010-12-31T00:00:00Z","timestamp":1293753600000},"content-version":"vor","delay-in-days":1825,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2006,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:italic>Objective.<\/jats:italic> To assess the birth of twins in rural Burkina Faso with respect to prevalence, mortality, and provision of obstetric care. <jats:italic>Methods.<\/jats:italic> A descriptive demographic analysis of population\u2010based and health service data was performed with multivariate modeling by Poisson regression. Health service data were derived from a document review in health facilities in the Nouna District for the years 1994\u20132001. The district hospital provides obstetric care for the entire district with its 252,000 population (1998). Population\u2010based data (deliveries, live births, deaths) were derived from the demographic surveillance system in the surveillance area within the Nouna District, Burkina Faso (population under surveillance: 30,988 in 1998). All births in the period from January 1, 1993 to December 31, 1998 (9,457 recorded deliveries with 9,610 live births) were included and followed up until April 30, 2002. The main outcome measures were the prevalence of twin delivery as well as age\u2010 and sex\u2010specific mortality risks. <jats:italic>Results.<\/jats:italic> Mortality of twins is high, with one out of three dying before reaching the age of five years \u2013 2.5 times the mortality risk of singletons. Among twins, mortality is particularly high in the neonatal period (RR 5.16; CI: 3.6\u20137.5) and in twins born to mothers above the age of 35 (RR 5.12; CI: 3.5\u20137.6). The overall population\u2010based prevalence of twin delivery is 1.6% (CI: 1.4\u20131.9) versus a hospital\u2010based prevalence of 2.8% (CI: 2.2\u20133.1). Despite this moderate trend towards hospital\u2010based obstetric care, most twins (90.5%) are still delivered outside a hospital setting. <jats:italic>Conclusions.<\/jats:italic> The high neonatal mortality in twins points to the need for special care in pregnancy, child birth, and postpartum. Maternity services fail to adequately cover the vast majority of multiple pregnancies and deliveries.<\/jats:p>","DOI":"10.1080\/00016340500324357","type":"journal-article","created":{"date-parts":[[2009,12,8]],"date-time":"2009-12-08T17:35:11Z","timestamp":1260293711000},"page":"26-32","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Multiple pregnancy in rural Burkina Faso: frequency, survival, and use of health services"],"prefix":"10.1111","volume":"85","author":[{"given":"ALBRECHT","family":"JAHN","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"GISELA","family":"KYNAST\u2010WOLF","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"BOCAR","family":"KOUYAT\u00c9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"HEIKO","family":"BECHER","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2010,12,31]]},"reference":[{"key":"e_1_2_6_2_2","first-page":"253","volume-title":"Mortality and Society in Sub\u2010Saharan Africa","author":"Pison G","year":"1992"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1080\/02724936.1998.11747952"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/29.4.678"},{"issue":"1","key":"e_1_2_6_5_2","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1177\/004947559702700110","article-title":"Observed versus expected obstetric complications: an assessment of coverage of obstetric care in developing countries","author":"Pittrof R","year":"1997","journal-title":"Trop Doct"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-3156.1998.00323.x"},{"issue":"17","key":"e_1_2_6_7_2","first-page":"317","article-title":"How can we monitor progress towards improved maternal health","author":"Ronsmans C","year":"2001","journal-title":"Studies in Health Service Organisation and Policy"},{"key":"e_1_2_6_8_2","volume-title":"WHO Antenatal Care Randomized Trial: Manual for the Implementation of the New Model","author":"WHO Antenatal Care Trial Research Group","year":"2002"},{"key":"e_1_2_6_9_2","volume-title":"Population and Health in Developing Countries, Vol. 1: Population, Health, and Survival in INDEPTH Sites","author":"Y\u00e9 Y","year":"2002"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/30.3.485"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/pubmed\/fdg080"},{"key":"e_1_2_6_12_2","first-page":"349","article-title":"Mortality patterns \u20131998 in a rural area of Burkina Faso, West Africa, based on the Nouna Demographic Surveillance System","volume":"2002","author":"Kynast\u2010Wolf G","year":"1993","journal-title":"Trop Med Int Health; 7"},{"key":"e_1_2_6_13_2","first-page":"265","article-title":"Risk factors of infant and child mortality in rural Burkina Faso","volume":"82","author":"Becher H","year":"2004","journal-title":"Bull World Health Organ."},{"key":"e_1_2_6_14_2","volume-title":"Cancer Epidemiology: Principles and Methods","author":"Dos Santos Silva I","year":"1999"},{"key":"e_1_2_6_15_2","volume-title":"SAS Procedures Guide. Version 8, first edition","author":"SAS Institute Inc","year":"2002"},{"key":"e_1_2_6_16_2","volume-title":"Statistical Methods in Cancer Research, Vol. II: The Design and Analysis of Cohort Studies","author":"Breslow NE","year":"1987"},{"key":"e_1_2_6_17_2","unstructured":"SAS Institute Inc.SAS\/STAT Software Changes & Enhancements. Cary NCUSA:SAS Institute Inc. 1997."},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-662-02489-8"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/00001648-199507000-00016"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/24.2.413"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/16.3.436"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1067\/S0002-9378(03)01054-8"},{"key":"e_1_2_6_23_2","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/15.1.1"},{"issue":"1","key":"e_1_2_6_24_2","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1177\/004947550303300105","article-title":"Where there is no ultrasound: delay and failure of antenatal diagnosis of twin pregnancy","volume":"33","author":"Groot MC","year":"2003","journal-title":"Trop Doct"},{"key":"e_1_2_6_25_2","first-page":"133","volume-title":"When to Screen in Obstetrics and Gynecology","author":"Berg CJ","year":"1996"},{"key":"e_1_2_6_26_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-3156.2000.00611.x"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1080%2F00016340500324357","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1080\/00016340500324357","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,15]],"date-time":"2023-10-15T20:39:21Z","timestamp":1697402361000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1080\/00016340500324357"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,1]]},"references-count":25,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2006,1]]}},"alternative-id":["10.1080\/00016340500324357"],"URL":"https:\/\/doi.org\/10.1080\/00016340500324357","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,1]]},"assertion":[{"value":"2010-12-31","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}