Size and morbidity in Malawian twins

Objective: Twins in developing countries may be disadvantaged due to their small size at birth, compromised nutrition and high infection risk. Although twinning is common in Africa, there are few longitudinal studies of growth and morbidity in this high-risk group. The aim of the present paper was to describe growth and morbidity of Malawian twins compared to singletons.

Methods: Morbidity episodes were recorded at 4 weekly intervals and at extra visits made to health centres for illness. Weight, length, head and arm circumference were recorded at birth and weight, length and MUAC at 4 weekly intervals to 52 weeks of age.

Results: Twins showed reduced fetal growth compared to singletons, with increasing fall-off in percentiles from 33 weeks gestation. Infant growth percentiles for twins were below those for singletons at all ages, but showed no fall-off from singleton percentile values. There were no differences in morbidity incidence during infancy between twins and singletons.

Conclusion: Malawian twins showed no catch-up growth during infancy, their smaller size was not associated with higher morbidity incidence compared to singletons.