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Multiple gestation: reflections on epidemiology, causes, and consequences.

L G Keith1, J J Oleszczuk, D M Keith

  • 1Department of Obstetrics and Gynecology, Northwestern University Medical School, and The Center for Study of Multiple Birth, Chicago, Illinois, USA.

International Journal of Fertility and Women'S Medicine
|August 10, 2000
PubMed
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Multiple births surged dramatically between 1971-1997 due to rising maternal age and infertility issues. This led to significantly higher rates of premature births, infant deaths, and long-term health problems for multiples.

Area of Science:

  • Reproductive Health
  • Perinatology
  • Public Health

Background:

  • Multiple births (twins, triplets, quadruplets, etc.) experienced an epidemic increase from 1971 to 1997.
  • This rise was observed across various racial and ethnic groups, with notable increases in twin births among white, Afro-American, Native American, and Mexican American women.

Purpose of the Study:

  • To analyze the trends in multiple births during a specific period.
  • To identify the primary causes contributing to the increase in multiple births.
  • To examine the immediate and long-term consequences of this trend on infant health and survival.

Main Methods:

  • The study analyzed birth data from 1971-1997.
  • It compared rates of multiple births, gestational age, birth weight, infant mortality, and long-term health outcomes (handicap, cerebral palsy) between singletons and multiples.

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  • Causal factors such as maternal age and fertility-inhibiting conditions were considered.

    • Main Results:

    • Twin births increased significantly across all studied demographics.
    • Triplet, quadruplet, and quintuplet+ births saw dramatic increases exceeding 400%, 1,100%, and 500%, respectively.
    • Infants from multiple births, especially triplets, faced substantially higher risks of prematurity (<33 weeks gestation), low birth weight (<1,500 g), infant mortality, handicap, and cerebral palsy compared to singletons.

    Conclusions:

    • The rise in multiple births is primarily attributed to increased maternal age and the prevalence of fertility-inhibiting conditions.
    • Multiple births are associated with severe adverse outcomes, including high rates of prematurity, mortality, and long-term disabilities.
    • Healthcare and survival costs for multiple births are significantly elevated due to prematurity-related complications and subsequent health issues.