Growth patterns and survival rates of twins in a rural area of Ghana: A follow-up study from birth to adulthood

This prospective and descriptive study was conducted to evaluate the growth and survival of twins during childhood and adolescence in the Agogo area of Ghana. It describes the outcome in 422 twin children born between 1969 and 1981. By 3 years of age, 40 (9.5%) of them had not reported again, fifteen of the remaining 382 had died and 367 (96%) were still alive. In 1993 and 2001, at 12-26 years of age, 33 children could not be traced; of the remaining 349 children, 17 more had died and 317 (91%) were still alive. Incremental weight gain in the 1st year of life was approximately 0.17 kg/month less than that of a reference group of USA twins. However, growth velocity was similar in the 2nd and 3rd years. From 6 to 36 months of age, Agogo twins were 0.9-1.3 kg lighter than a reference group of Agogo singletons. In both males and females, the physiological growth spurt of puberty occurred approximately 2 years later than in Agogo singletons. By adulthood, mean heights and weights, particularly of female twins, still lagged behind those of the local reference group. Twins have a good chance of surviving childhood although they can be considered to be at high risk, particularly during the 1st year of life. Up to adulthood, growth potential seems to be less than that of their singleton counterparts.