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APHA Scientific Session and Event Listing

Melissa M. Park, MPH, Maternal and Child Health, University of North Carolina at Chapel Hill, CB# 7445, Rosenau Hall, Chapel Hill, NC 27599-7445, 919-933-5684, mmpark@email.unc.edu

Infants born in twin, triplet, and quadruplet sets have a lower mean gestation and a higher rate of preterm birth compared to their singleton counterparts. Preterm infants are at much higher risk of morbidity and mortality overall, yet infants born in multiple sets fare better than singletons at certain gestation-specific comparisons on the lower end of the gestation distribution. Characteristics of the uterine environment that are unique to multiple birth sets, such as the gender make-up of the set, may influence the ultimate outcome and survival of the infant. This study employs several analytical approaches in an effort to better understand the origins of both singleton versus multiple gestation disparities and twin/triplet/quadruplet gestation comparisons. Data for the study consists of matched multiple birth sets for combined years 1995 through 2000 in the United States. This dataset was derived from individual birth record files of the vital statistics system. Regression models were estimated to examine the unadjusted and adjusted (for common socio-demographic and maternal risk factors) effects of multiplicity on gestation. Separate models for twin, triplet, and quadruplets were estimated to identify group differences in how key risk factors affect gestation. Finally, quantile regression models were estimated in an effort to identify risk factors whose effects vary at different locations along the gestation distribution. Some variation in the effects of key risk factors on gestation were observed across multiple sets. Implications of our findings for research on clinically useful gestation cutpoints for twin, triplet, and quadruplet infants are discussed.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will learn

• Multiple gestation pregnancies are at higher risk of preterm delivery compared to singletons.
• Gestation points at highest risk for infant mortality are presented for multiple births.

Presenting author's disclosure statement:

Not Answered