{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T19:01:12Z","timestamp":1777057272362,"version":"3.51.4"},"reference-count":28,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2022,9,29]],"date-time":"2022-09-29T00:00:00Z","timestamp":1664409600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Twin pregnancy carries a high risk of pregnancy-related complications including adverse perinatal outcomes. Although evidence from international studies indicated an increased risk of adverse perinatal outcomes in twin pregnancies, little is known about the adverse perinatal outcomes in twin pregnancies and associated factors in Ethiopia. The purpose of this study was, therefore, to estimate the incidence of twin pregnancies and related-adverse perinatal outcomes and identify factors associated with adverse perinatal outcomes in twin pregnancies in Ethiopia.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A hospital-based retrospective cross-sectional study was conducted among 322 mothers who gave twin birth at Adama Hospital Medical College between 08 July 2015 and 07 June 2017. In this study, the adverse perinatal outcome was defined as the presence of any of the following main conditions: low birth weight, preterm birth, stillbirth, low Apgar Scores, mal-presentation, Admission to neonatal Intensive Care Unit (NICU), and early neonatal deaths. The data were analyzed using SPSS version 20.0. Multivariable logistic regression was conducted to identify factors associated with adverse perinatal outcome at 95% CI or P-value of less than 0.05.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Result<\/jats:title>\n<jats:p>Of 10,850 births recorded in the hospital, 354 births were twins and 322 of these paired records had complete perinatal information. One hundred ninety-nine (61.8%) of the 322 paired birth records had at least one adverse perinatal outcome on one or both twins. Low birth weight was the most common perinatal outcome followed by preterm birth. After adjusting for confounding factors, younger maternal age (AOR = 4.1, 95% CI; 1.3, 12.5) and not having ultrasound scan during antenatal care (AOR = 2.0, 95% CI: 1.2, 3.1) were significantly associated with adverse perinatal outcomes.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The incidence of adverse perinatal outcome in twin pregnancies was high, that is, in 61.8% of twin births, there was at least one adverse perinatal outcome on one or both twins. Moreover, younger maternal age at birth and not having an ultrasound scan during antenatal care were found to be strong predictors for the observed high incidence of adverse perinatal outcomes.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0275307","type":"journal-article","created":{"date-parts":[[2022,9,29]],"date-time":"2022-09-29T19:07:35Z","timestamp":1664478455000},"page":"e0275307","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Perinatal outcome of twin pregnancies among mothers who gave birth in Adama Hospital Medical College, Central Ethiopia"],"prefix":"10.1371","volume":"17","author":[{"given":"Mekonen","family":"Beyene","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meyrema","family":"Abdo Komicha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hassen","family":"Hussien","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anwar","family":"Abdulwahed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tahir Ahmed","family":"Hassen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6227-9594","authenticated-orcid":true,"given":"Kedir Teji","family":"Roba","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2022,9,29]]},"reference":[{"issue":"6","key":"pone.0275307.ref001","doi-asserted-by":"crossref","first-page":"1666","DOI":"10.1093\/humrep\/deab029","article-title":"Twin Peaks: more twinning in humans than ever before","volume":"36","author":"C Monden","year":"2021","journal-title":"Hum Reprod"},{"issue":"3","key":"pone.0275307.ref002","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1016\/j.fertnstert.2016.05.026","article-title":"Society for Assisted Reproductive Technology and assisted reproductive technology in the United States: a 2016 update","volume":"106","author":"JP Toner","year":"2016","journal-title":"Fertility and sterility"},{"issue":"5","key":"pone.0275307.ref003","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1001\/jamapediatrics.2019.6096","article-title":"Associations of Assisted Reproductive Technology and Twin Pregnancy With Risk of Congenital Heart Defects","volume":"174","author":"SW Wen","year":"2020","journal-title":"Jama, Pediatr"},{"issue":"6","key":"pone.0275307.ref004","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1016\/S1701-2163(16)34909-X","article-title":"Multiple births associated with assisted human reproduction in Canada.","volume":"33","author":"JL Cook","year":"2011","journal-title":"Journal of Obstetrics and Gynaecology Canada"},{"issue":"2","key":"pone.0275307.ref005","doi-asserted-by":"crossref","first-page":"93","DOI":"10.5468\/ogs.2019.62.2.93","article-title":"Perinatal outcome of twin pregnancies according to maternal age","volume":"62","author":"Y-j Lee","year":"2019","journal-title":"Obstetrics & gynecology science"},{"issue":"1","key":"pone.0275307.ref006","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1017\/thg.2014.82","article-title":"Multiple births in sub-Saharan Africa: epidemiology, postnatal survival, and growth pattern","volume":"18","author":"S. Gebremedhin","year":"2015","journal-title":"Twin Research and Human Genetics"},{"issue":"4","key":"pone.0275307.ref007","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1007\/s00404-018-4656-1","article-title":"The impact of advanced maternal age on the outcome of twin pregnancies","volume":"297","author":"O Gluck","year":"2018","journal-title":"Archives of gynecology and obstetrics"},{"issue":"9","key":"pone.0275307.ref008","doi-asserted-by":"crossref","first-page":"e25239","DOI":"10.1371\/journal.pone.0025239","article-title":"Twinning across the developing world","volume":"6","author":"J Smits","year":"2011","journal-title":"PLoS ONE"},{"issue":"2","key":"pone.0275307.ref009","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1093\/humupd\/5.2.179","article-title":"The epidemiology of multiple births","volume":"5","author":"R Bortolus","year":"1999","journal-title":"Human reproduction update"},{"key":"pone.0275307.ref010","volume-title":"Semin Perinatol","author":"BC Young","year":"2012"},{"issue":"1","key":"pone.0275307.ref011","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12884-018-2082-9","article-title":"Perinatal outcomes in twin pregnancies complicated by maternal morbidity: evidence from the WHO Multicountry Survey on Maternal and Newborn Health","volume":"18","author":"DS Santana","year":"2018","journal-title":"BMC pregnancy and childbirth"},{"key":"pone.0275307.ref012","article-title":"Maternal and perinatal outcome among multiple pregnancies delivering at Bugando Medical Centre and Sekou Toure Regional Hospital in Mwanza, Tanzania: Tesis","author":"L Markus","year":"2013","journal-title":"Tanzania"},{"issue":"2","key":"pone.0275307.ref013","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1002\/ijgo.13107","article-title":"Maternal and perinatal outcomes and factors associated with twin pregnancies among preterm births: Evidence from the Brazilian Multicenter Study on Preterm Birth (EMIP).","volume":"149","author":"DS Santana","year":"2020","journal-title":"International Journal of Gynecology & Obstetrics"},{"issue":"1","key":"pone.0275307.ref014","first-page":"83","article-title":"Maternal complications in twin pregnancies. Mymensingh medical journal","volume":"20","author":"S Chowdhury","year":"2011","journal-title":"MMJ"},{"issue":"1","key":"pone.0275307.ref015","first-page":"1","article-title":"Maternal complications in twin pregnancies in Finland during 1987\u20132014: a retrospective study.","volume":"19","author":"A-RS Rissanen","year":"2019","journal-title":"BMC pregnancy and childbirth"},{"issue":"4","key":"pone.0275307.ref016","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1515\/jpm-2012-0175","article-title":"Trends in twin pregnancies and mode of delivery during the last 30 years: inconsistency between guidelines and clinical practice.","volume":"41","author":"A Antsaklis","year":"2013","journal-title":"J Perinat Med"},{"issue":"2","key":"pone.0275307.ref017","doi-asserted-by":"crossref","first-page":"82","DOI":"10.5694\/mja2.50402","article-title":"Changes in the modes of twin birth in Victoria, 1983\u20132015","volume":"212","author":"Y Liu","year":"2020","journal-title":"Medical Journal of Australia"},{"issue":"6","key":"pone.0275307.ref018","doi-asserted-by":"crossref","first-page":"F542","DOI":"10.1136\/adc.2003.043851","article-title":"Economic implications of multiple births: inpatient hospital costs in the first 5 years of life.","volume":"89","author":"J Henderson","year":"2004","journal-title":"Archives of Disease in Childhood-Fetal and Neonatal Edition"},{"issue":"4","key":"pone.0275307.ref019","first-page":"217","article-title":"Incidence and some perinatal problems of multiple pregnancies in a central referral hospital, Addis Ababa.","volume":"27","author":"V Korsak","year":"1989","journal-title":"Ethiopian medical journal"},{"issue":"1","key":"pone.0275307.ref020","first-page":"55","article-title":"Twin deliveries in a zonal hospital: ten years retrospective study.","volume":"45","author":"A. Gessessew","year":"2007","journal-title":"Ethiopian medical journal"},{"issue":"1","key":"pone.0275307.ref021","first-page":"21","article-title":"The frequency of multiple births in Gondar Hospital northwestern Ethiopia","volume":"27","author":"A. Zein","year":"1989","journal-title":"Ethiopian medical journal"},{"issue":"1","key":"pone.0275307.ref022","doi-asserted-by":"crossref","first-page":"134","DOI":"10.4314\/star.v4i1.23","article-title":"Perinatal complications of twin deliveries at Jimma University specialized hospital, Southwest Ethiopia: a facility-based cohort study","volume":"4","author":"T Tilahun","year":"2015","journal-title":"Science, Technology and Arts Research Journal"},{"issue":"8","key":"pone.0275307.ref023","doi-asserted-by":"crossref","first-page":"e70549","DOI":"10.1371\/journal.pone.0070549","article-title":"Maternal and perinatal outcomes of twin pregnancy in 23 low-and middle-income countries","volume":"8","author":"JP Vogel","year":"2013","journal-title":"PLoS ONE"},{"issue":"4","key":"pone.0275307.ref024","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1016\/j.ajog.2010.04.031","article-title":"Twins: prevalence, problems, and preterm births","volume":"203","author":"SP Chauhan","year":"2010","journal-title":"American journal of obstetrics and gynecology"},{"key":"pone.0275307.ref025","first-page":"227","article-title":"Twin versus singleton pregnancies: the incidence, pregnancy complications, and obstetric outcomes in a Nigerian tertiary hospital","volume":"3","author":"N Obiechina","year":"2011","journal-title":"International journal of women\u2019s health"},{"issue":"5","key":"pone.0275307.ref026","first-page":"317","article-title":"Obstetrics and perinatal outcomes of dichorionic twin pregnancy following ART compared with spontaneous pregnancy","volume":"14","author":"L Pourali","year":"2016","journal-title":"International Journal of Reproductive BioMedicine"},{"issue":"4","key":"pone.0275307.ref027","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1590\/S0104-42302010000400018","article-title":"Perinatal outcome of twin pregnancies delivered in a teaching hospital","volume":"56","author":"RAd Assun\u00e7\u00e3o","year":"2010","journal-title":"Revista da Associa\u00e7\u00e3o M\u00e9dica Brasileira"},{"issue":"1","key":"pone.0275307.ref028","doi-asserted-by":"crossref","first-page":"80. e1","DOI":"10.1016\/j.ajog.2017.03.002","article-title":"The role of maternal age in twin pregnancy outcomes","volume":"217","author":"AS McLennan","year":"2017","journal-title":"American journal of obstetrics and gynecology"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0275307","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,29]],"date-time":"2022-09-29T19:08:12Z","timestamp":1664478492000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0275307"}},"subtitle":[],"editor":[{"given":"Filomena Giulia","family":"Sileo","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2022,9,29]]},"references-count":28,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2022,9,29]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0275307","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,29]]}}}