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Mothers who experienced an antepartum haemorrhage and those with a multiple birth were somewhat more likely to be graded as having poor physical grade.
But the aOR's of pregnancy hypertension for multiple birth were nearly identical for the two classification methods.
Women with a known multiple gestation pregnancy or who had a multiple birth were excluded at enrolment or during the study.
With all child-, maternal-, household-specific and other factors controlled, children born multiple birth were more than twice as likely to die during infancy as infants born singleton (HR = 2.19; 95% CI: 1.50, 3.19).
Younger mothers, those who smoked during pregnancy, and had fewer prenatal care visits were more likely to deliver a LBW child; moreover, preterm newborns, delivered by caesarean section, and twin or multiple birth were significantly more likely to have a LBW.
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The rate of premature birth is steady at 7.3%, though motherhood at 40 or over and multiple birth are both risk factors for prematurity.
"A multiple birth is the single highest risk to the success of pregnancy, the health of the child and the health of the mother," Jardine said.
Second time round, she says, "I felt a little stupid that I didn't consider it might be twins, because with in vitro [fertilisation], multiple birth is very common.
Multiple birth was associated with increased odds of caesarean section only in urban India and rural Nepal.
Multiple birth was found to be associated with over threefold increase in perinatal mortality compared with singleton births (AOR = 3.9; 9% CI 2.93-5.32; p < 0.001).
Only the first newborn in a multiple birth was retained for analysis, as characteristics of the subsequent newborns were unlikely to be independent.
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