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Mortality and morbidity among twins: recent observations from the United States
1Department of Obstetrics and Gynecology, Northwestern University Medical School, Prentice Women's Hospital and Maternity Center of Northwestern Memorial Hospital.
Insights
Twin births pose national health concerns due to higher rates of preterm delivery and low birthweight. Adequate maternal nutrition is proposed to improve outcomes and reduce infant mortality and handicap risks.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Health
- Public Health
Background:
- Rising rates of multiple births (twins and higher-order multiples) present significant public health challenges.
- Multiple gestations are associated with increased risks of preterm delivery and low birthweight compared to singleton pregnancies.
- These infants disproportionately contribute to infant mortality, morbidity, and long-term developmental handicaps.
Purpose of the Study:
- To analyze birth data from 1987-1988 to assess risks associated with twin births.
- To compare rates of preterm delivery, low birthweight, mortality, and handicap in twins versus singletons.
- To propose interventions for improving outcomes in multiple births.
Main Methods:
- Utilized U.S. birth data from 1987 and 1988.
- Calculated distribution frequencies for gestational age and birthweight.
- Determined mortality and handicap rates and relative risks for twins compared to singletons.
Main Results:
- Identified differential rates of preterm delivery (< 37 weeks) and low birthweight (< 2,500g) in twins compared to singletons.
- Quantified the elevated risks of mortality and handicap for infants from twin pregnancies.
- Established the significant contribution of twins to adverse infant health outcomes.
Conclusions:
- Twin births necessitate focused public health attention due to associated risks.
- Adequate maternal nutrition during pregnancy is proposed as a key prenatal intervention.
- Implementing nutritional support may reduce mortality, handicap rates, and healthcare costs for surviving infants.
Abstract:
The increasing number of twin (and higher order) births is a matter of national concern for two reasons: First, the differential rates of preterm (< 37 weeks) delivery and low birthweight (< 2,500g) among twins compared to singletons; and second, the inordinate contribution of these infants to overall infant mortality, morbidity and long-term handicap. Data from all births in the U.S. during 1987 and 1988 was used to calculate distribution frequencies for gestational age at delivery, and birthweight, as well as mortality and handicap rates and the corresponding relative risks of these latter events for twins compared to singletons. A suggestion for improvement in the mortality and handicap rates and reduced costs among survivors is presented. This proposal is based upon data from the singleton and twin literature and the use of the prenatal invervention of adequate maternal nutrition during the pregnancy.