Newborn twins are a vulnerable group in Guinea-Bissau and elsewhere in Africa

Yet, few studies have examined what happens after hospital discharge. In Guinea-Bissau we found that the post-perinatal infant mortality rate of twins was double that of singletons. No excess in twin hospitalisations was observed, possibly implying obstacles to hospital admission for twins in case of severe illness.

In this paper, we examined post-perinatal mortality and hospitalizations until one year of age, compared to singletons. Twins had a two-fold excess mortality, particularly during the first three months of life. Among risk factors were very low birth weight, loss of the co-twin perinatally and maternal illness, including HIV infection. Surprisingly, twins were not hospitalized more often than singletons. In conclusion, our findings warrant further attention to newborn twins after hospital discharge, as they clearly are a high risk group. More studies are also needed in terms of health seeking behavior in twin families, including possible impediments to hospitalization in case of severe illness.