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[Multiple births in the Netherlands].

Tina J Glasner1, Catharina E M van Beijsterveldt, Gonneke Willemsen

  • 1Vrije Universiteit Amsterdam, afd. Biologische Psychologie/Nederlands Tweelingen Register, Amsterdam, the Netherlands. t.j.glasner@vu.nl

Nederlands Tijdschrift Voor Geneeskunde
|July 30, 2013
PubMed
Summary

The twin birth rate in the Netherlands declined between 2005-2011. While single embryo transfer in IVF reduced dizygotic twins, monozygotic twins persist, impacting multiple pregnancies and infant outcomes.

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Area of Science:

  • Reproductive Medicine
  • Perinatology
  • Epidemiology

Background:

  • Twin birth rates rose in the late 20th century due to increases in both dizygotic and monozygotic twins.
  • Assisted reproductive technologies, particularly In Vitro Fertilization (IVF), have influenced twin conception rates.
  • Despite advancements, multiple pregnancies carry higher risks of stillbirth and infant death compared to singleton pregnancies.

Purpose of the Study:

  • To analyze trends in twin birth rates in the Netherlands.
  • To investigate the impact of IVF, specifically single embryo transfer, on dizygotic and monozygotic twinning.
  • To assess the implications of declining twin rates on perinatal outcomes.

Main Methods:

  • Analysis of national birth data from the Netherlands between 2005 and 2011.
  • Examination of IVF treatment data, focusing on twin pregnancy rates and types (dizygotic vs. monozygotic).
  • Comparison of perinatal mortality and gestational age in multiple vs. singleton pregnancies.

Main Results:

  • The twin birth rate in the Netherlands decreased from 18.6 to 15.9 per 1000 deliveries between 2005 and 2011.
  • IVF single embryo transfer led to a significant reduction in dizygotic twins, but monozygotic twinning rates remained a concern.
  • Twin pregnancies after IVF dropped from 21.7% in 2003 to 8.5% in 2011, with a decrease in average gestational age for both twin types.

Conclusions:

  • The decline in twin births is partly attributable to changes in IVF practices.
  • While dizygotic twinning has decreased, the persistence of monozygotic twins in IVF pregnancies warrants continued attention.
  • Multiple pregnancies, even with declining rates, continue to present elevated risks for adverse perinatal outcomes.