Role of multiple births in very low birth weight and infant mortality
Department of Obstetrics and Gynecology
Medical Subject Headings
Adult; Birth Certificates; *Cause of Death; Confidence Intervals; Female; Humans; Incidence; Infant Mortality; Infant, Newborn; *Infant, Very Low Birth Weight; Massachusetts; Maternal Age; Multiple Birth Offspring; Multivariate Analysis; Pregnancy; Prenatal Care; Public Health; Registries; Risk Assessment
Maternal and Child Health | Obstetrics and Gynecology | Women's Health
OBJECTIVE: To determine the percentage of very-low-birth-weight (VLBW) infants (g) and infant deaths attributable to multiple births in the general population and in women aged 35+.
STUDY DESIGN: The year 2000 Massachusetts birth certificate database with linked births-deaths was examined. Etiologic fractions (EF) for VLBW and infant mortality attributable to multiples were calculated for the general population and the 35+ age group. The percentages of multiples occurring in the 35+ age group were calculated. Infant deaths due to congenital anomalies and "perinatal conditions" were calculated.
RESULTS: There were 81,582 resident births in Massachusetts in 2000. Of them 4.3% were multiples. Of the 1090 VLBW infants, 26.1% (95% CI: 23.5-28.8) were in twins and 7.7% (95% CI: 6.2-9.5) in higher-order multiples, yielding an EF of 30.8% for multiples in VLBW. In the 35+ age group, the multiple birth ratio was 6.6% (95% CI: 6.3-7.0). The EF for multiples and VLBW in this age group was 33.7%. The 35+ age group accounted for 32.4% (95% CI: 30.8-34.0) of twins and 45.5% (95% CI: 39.1-52.0) of higher-order multiples born in 2000. Of the 392 infant deaths, 57 (14.6%; 95% CI: 11.2-18.4) were attributed to congenital anomalies, and 236 (60.2%; 95% CI: 55.2-65.0) to "perinatal conditions." Multiples were responsible for 8 (14%; 95% CI: 6.3-25.8) of deaths due to anomalies, and 73 (30.9%; 95% CI: 25.1-37.3) due to "perinatal conditions."
CONCLUSION: Over 30% of VLBW infants, nearly 20% of infant mortality and >30% of infant mortality due to perinatal conditions could be attributed to multiples. Multiple pregnancy is a significant public health problem.
Rights and Permissions
Citation: J Reprod Med. 2004 Oct;49(10):812-6.
infant, very low birth rate, multiple birth offspring, infant mortality
Magee, B. Dale, "Role of multiple births in very low birth weight and infant mortality" (2004). Obstetrics and Gynecology Publications and Presentations. 98.