Over the last two decades the number of twin and triplet births have increased at a remarkable pace; twin births by more than 50% and triplets by more than 400%. These births are at much greater risk than singletons of morbidity and early mortality. Although on the decline in recent years, infant mortality rates for twins continue to be 4 times higher, and triplets 10 times higher than those of singletons. The US natality files from the National Center for Health Statistics include substantial demographic and health data on each multiple born in the US, but individual records of multiples are not matched into sets in this file. As a result, crucial characteristics which can only be studied within sets, cannot be analyzed. This study uses information from restricted-use natality and fetal death files to match sets of live births and fetal deaths in multiple deliveries for 1995-97. Greater than 96% of all records were matched. Corresponding infant deaths were included. Findings: PMRs ranged widely by infant and maternal characteristics. Risk was lowest for female/male twin sets (35.5 per 1,000), intermediate for female/female (51.0), and highest for male/male twins (60.9) The risk of death for a twin female/male pregnancy of a women 35 years or older (16.0 per 1,000) was comparable to that of a teenage singleton pregnancy (16.9). PMRs for unlike-gender pairs rose signficantly at a much higher birthweight discordancy threshold (% of birthweight difference between set mates) than like-gender pairs.
Learning Objectives: At the conclusion of this presentation the participants will be able to: 1. Articulate the importance of the study of multiple births. 2. Assess the perinatal risk of a twin or triplet pregnancy by clearly defined, readily available maternal and fetal characteristics
Keywords: Infant Mortality, Perinatal Health
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.