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At least 19 recordsLinked to original sources
PubMed1990

The probability of multiple births when multiple gestational sacs or viable embryos are diagnosed at first trimester ultrasound.

The live birth outcome when multiple gestational sacs were diagnosed at first trimester ultrasound was reviewed in 227 twin, 43 triplet and five quadruplet pregnancies. When two gestational sacs were present, the probability of delivering twins was 63% for maternal age less than 30 and 52% for maternal age greater than or equal to 30. With three gestational sacs, the probability of a triplet birth was 45% for maternal age less than 30 and 18% for maternal age greater than or equal to 30. When two viable embryos were present, the probability of a twin birth was 90% for maternal age less than 30 and 84% for maternal age greater than or equal to 30. With three viable embryos, the probability of a triplet birth was 90% for maternal age less than 30 and 44% for maternal age greater than or equal to 30. Two gestations resulting from ovulation induction with clomiphene citrate were more likely to result in twin delivery at term, compared to spontaneous twin gestations (P = 0.012). These findings may be useful in the treatment and management of patients when multiple gestations are diagnosed early in pregnancy.

Adult↗
PubMed1976

[Genetico-statistical analysis of multiple birth factors in man. III. Component analysis of multiple birth factors].

Based on the component analysis of correlation matrices for five indicies (parents' age by the moment of twin birth, the number of proband's pregnancy, the beginning of mother's coitus and menarche) characterizing four specified family groups (MZ and DZ load multiple birth and MZ and DZ sporadic multiple birth) at least 6 independent trends of multiple birth factors influence have been revealed. Gases of burdened and sporadic multiple birth turned out to differ in some of the specific trends. At the same time while cases of MZ and DZ load multiple birth differ in some of the trends, they appear to be much more similar to one another than those of MZ and DZ sporadic multiple birth. The data obtained make it possible to assert that first, according to the mechanism of the appearance, there exist at least four main multiple birth groups, specified above, and second, there are multiple birth factors being both common to all groups and specific to each of them separately. At this some of the defined factors influence mainly as implementing hereditary determined trend to multiple burth, while the others in the absence of predisposing genotype perform apparently as casual. The present study data confirm the concept, formed on the basis of genealogical analysis, that genetical factors involved in the determination of MZ and DZ multiple birth are of definitely common character. In addition to that the results of the study make it possible to conclude that multiple aproach in the statistical analysis of quantitative characteristics (multiple birth factors in the present case) is extremely sensitive and results in non-routine conclusions the effects of which can be directly changed.

Age Factors↗
PubMed1976

[Genetic-statistical analysis of multiple births in humans. I. Genetic analysis of predisposition to multiple birth].

Genetico-statistical analysis was made to check various hypotheses of the tendency to multiple birth inheritance. The material involved was comprised of 115 MZ and 228 DZ twin families burdened by recurrent cases of multiple births in their genealogy. Test data included 516 single birth probands, 5 from which had twins among sibs; this results in p = 0,97% for the evaluation of population frequency of the "affected" couples having twins). Vienberg proband method was applied to check monogenous-autosomal model and Edward & Smith approximating formulae to check additive-polygenous model with liminal results (manifestation). It is shown: 1) that the degree of genetical determination of MZ and DZ twinning is approximately the same for both multiple birth types; H-61 and 53% respectively; 2) in MZ twinning both mother's and father's genotypes perform as multiple birth factors; H-76% for the group of mother's sisters and 64% for that of father's brothers; 3) in case of DZ twinning mother's genotype is much more valid as a multiple birth factor as compared to the father's one; H-68% for the group of mother's sisters and H-25% for father's brothers; 4) at least some genetical factors, involved in multiple birth determination, are common for MZ and DZ twins; the rate of DZ twinning (of different sexes) among sibs of parents of MZ twins is reliable and more than 5-fold increases that in common population. It is suggested that the contradiction of literary data on multiple birth genetics is due to unadequate methods in many early investigations: calculations have been carried out on the basis of twin birth rate, and not on the rate of "affected" (couples having twins); differential Veinberg's method has been used, which is adequate in populational analysis and is unsuitable for genealogical studies for the estimation of MZ and DZ twinning frequency; cases of "sporadic" multiple birth have not been excluded from summary family material. On the basis of the authors' and literary data it is suggested also that the number of main genetic factors determining the tendency to multiple births is more than 2 (probably 3) and does not exceed 5, and their interaction approximated by oligenic-complementary model, which does not exclude the presence of genocopying loci in a total system.

Adolescent↗
PubMed1992

Disseminated herpes simplex infection in a twin: the role of the "stat" autopsy in immediate therapeutic intervention for survival of multiple birth neonates.

Multiple birth neonates are unique in sharing similar intrauterine, and commonly the extrauterine, environments. The development of an infectious disease in one infant during the perinatal period assumes special significance in this setting, and the other siblings are often at high risk for a similar disease. Under these circumstances it is important to make a rapid etiologic diagnosis to provide appropriate therapeutic intervention. The immediate, or "stat", autopsy is a diagnostic modality involving the use of multiple procedures for the rapid diagnosis of perinatal infection which may be lifesaving in the setting of multiple birth neonates. This report describes the use of the "stat" autopsy to diagnose a fatal case of disseminated herpes simplex infection in a twin, which lead to the immediate treatment of the surviving sibling with appropriate antiviral medication.

Acyclovir↗
PubMed1976

[Low weight and endangering of multiple birth infants].

Multiple pregnancy represents a high risk to the survival of fetuses since insufficient nutrition frequently results in hypotrophic development and low birth weight. The frequency of the occurrence of low birth weight in children from a multiple birth is 10 times higher than in all newborn children and the early noenatal mortality of children froma multiple birth is 8 times higher than that of all newborn infants. The disproportion between the placenta and the fetuses which we usually find in multiple pregnancies may result in the occurrence of cerebral damage. In the period 1965 to 1967 perinatal death associated with cerebral damage by birth injury (recorded on the death certificate) accounted for 5,7% of all children of low birth weight and for 0,2% of children weighing at birth over 2500 g.

Birth Injuries↗
PubMed1990

Triplets and higher order multiple births in Japan.

Multiple birth rates in entire Japan were analyzed using vital statistics for 1951 to 1988. The triplet rate was nearly constant from 1951 to 1974, where the rate per million births was 58, then increased with the year up to 1982 (104), and decreased up to 1984, and suddenly increased thereafter (109 in 1987). The average rate of quadruplets per million births from 1951 to 1968 was 0.93, then increased with the year up to 1975 (7.5), and decreased until 1984 and suddenly increased thereafter (10.6 in 1987). The rate of quintuplets was 0.77 per million births during the period from 1975 to 1987. The higher multiple birth rate since 1975 was attributed to the higher proportion of mothers treated with ovulation-inducing hormones in Japan. Since 1985, higher multiple birth rates might be partially attributed to in vitro fertilization. The stillbirth rates for male triplets gradually decreased from 1960 to 1978 and thereafter remained constant at a little higher level except in 1988, whereas the rates for females gradually decreased with the year. The overall stillbirth rates decreased to 1/4 for triplets and to 1/5 for quadruplets during the 37-year period from 1951. The overall stillbirth rate of quintuplets was 0.60 (51/85) during the period 1975-1987.

Adult↗
PubMedDate not supplied

Current and future impact of rising multiple birth ratios on low birthweight.

Before 1980, multiple births with their increased risk of low birthweight comprised too small a proportion of births in the United States to have a significant impact on overall low birthweight levels; the recent steep rise in the multiple birth ratio has heightened their influence, however. Between 1980 and 1992 the white multiple birth ratio rose from 18.5 to 24.0 multiple births per 1,000 births. While the overall level of white low birthweight newborns increased slightly between 1980 and 1992 (from 5.7 percent to 5.8 percent), low birthweight for white singletons actually improved, declining from 4.9 to 4.7 percent. Thus, the increase in overall white low birthweight levels is a reflection of the increase in white multiple births and, to a much lesser extent, of the small increase in low birthweight among these births. Black multiple birth ratios and overall low birthweight also rose in this period. The black multiple birth ratio increased from 24.4 in 1980 to 28.2 per 1,000 births in 1992, and low birthweight rose from 12.7 to 13.3 percent. Although low birthweight for black singletons also increased (from 11.5 percent to 11.8 percent), the increase was at a slower pace than for all pluralities combined. Thus, for both white and black births, overall trends in low birthweight mask the disparate patterns of singleton and multiple births. It is, therefore, essential to examine low birthweight trends by plurality to assess accurately changes in this key indicator of infant health.

Adult↗
PubMed1997

Trends in multiple births, 1938-1995.

Information about multiple births has been collected at birth registration in England and Wales since 1938. This article describes the changes and trends in the prevalence of multiple births since that date. Particular attention is given to the increasing incidence of multiple births since the mid-1970s. Geographical variations in multiple births and differences by social class (based on occupation) are analysed. Age at motherhood is found to be a significant factor influencing the changes since 1938.

Age Distribution↗
PubMed1979

Multiple births in former oral contraceptive users.

Multiple births were studied in a cohort of 2953 former oral contraceptive users and 13,630 controls, all the women were interviewed post partum. There were 238 multiple births, a rate of 14.4/1000 deliveries. Former oral contraceptive users had 13.5/1000 sets of multiple births compared to 14.5/1000 in the controls. When women who had received treatment for anovulation were excluded, these rates were 11.1 and 12.7/1000 respectively, a difference which is not statistically significant. There was, however, a significant deficit of multiple births among the small group of former pill users who were underweight in relation to their height at the time of conception. Multiple births were also increased after stopping sequential pills and preparations containing high doses of oestrogen, and there was an excess of multiple births following breakthrough pregnancies. These findings, although statistically significant, are based on small numbers, and require confirmation from other studies.

Adult↗
PubMedDate not supplied

Higher multiple births: socio-economic implications in a developing nation.

A case of successful quadruplet pregnancy followed from date of diagnosis, through delivery, and to the third year of life is presented. The emotional, social, and economic problems encountered by the parents and hospital personnel are examined with a detailed analysis of the financial burden placed on all parties. Individual, voluntary donations made at the time of delivery have proved insufficient to cover the care involved before, during, and after the birth of multiples. A more concrete commitment on the part of government in the form of legislation or subvention is suggested in order to ease some of the stress on the parents of multiples.

Adult↗
PubMedDate not supplied

Trends in multiple births.

Since the early 1970s, the number and rate of multiple births have increased fairly steadily. Of the 4,110,907 babies born in the United States in 1991, 98,125 (2.4 percent) were twins, triplets or other higher order plural births. The 1991 rate of 23.9 multiple births per 1,000 live births--the highest recorded in this country in the last 50 years--was 1.3 percent higher than that in 1990, and 14 percent higher than the rate in 1985. The twins proportion of all multiple births has been slowly decreasing--97.6 percent in 1985, 96.9 percent in 1990 and 96.6 percent in 1991. Rates of multiple births continue to be higher among black women than white (2.8 and 2.3 per 1,000 live births, respectively, in 1991) and are more prevalent among older women. In 1991 the rates were higher through each age group to a high of 3.4 for white and 3.6 for black mothers aged 35-39 before dropping to 1.9 and 0.5, respectively, among 45- to 49-year-olds. Incidence of low birthweight (< 2,500 grams) and of very low birthweight (< 1,500 grams) babies were more frequent among multiple births than singletons and were more common among black than white infants. The median weight for white singleton births was 3,420 grams versus 2,260 grams for black plural births. The District of Columbia, Michigan and Massachusetts registered the highest percentage of multiple births in 1991 (2.9 to 2.7 percent) and the lowest rates were recorded in New Mexico and Wyoming (1.9 percent).

Black or African American↗
PubMed1990

An agenda for meeting the special needs of multiple birth families.

Over 80,000 multiple birth babies are born each year in the U.S. Their families must cope with a constellation of complex physical and psychosocial challenges, which jeopardizes their health and functioning. The demands of twin pregnancy and the parenting of twins, triplets, quadruplets, quintuplets or more puts these families at disproportionately high risk for infant mortality, birth defects, child abuse, substance abuse, financial problems and marital problems. Health and social service resources must be developed to alleviate the stresses associated with multiple birth and to empower parents to cope well. Guidelines for policies, parent education, professional training and service delivery developed for the California Department of Health Service, Maternal and Child Health Branch, are here offered for the consideration of policy makers and public health planners.

Family↗
PubMed1988

Essential nonmedical perinatal services for multiple birth families.

Parents of multiples suffer unique stresses which can severely impair family health and welfare. Access to information, counseling, and community resources increase parents' abilities to cope, and reduce the risk of child and spousal abuse. Twinline, a social service agency in California, provides a variety of free and low-cost nonmedical perinatal services to meet the needs of a heterogeneous population of over 1,000 multiple birth families and parents expecting multiples in the urban and rural counties of the San Francisco Bay Area.

California↗
PubMed1980

Multiple births in Hausa women.

The incidence of multiple births was studied using the maternity records of 5750 Hausa women living in the savannah zone of Nigeria. There were 40 twins and 2 triplets/1000 births. Twenty six per cent of twins were monozygous. The incidence of multiple births, which was about five times higher than that observed in any western population, was significantly lower than that of other ethnic groups, who live in the hot and humid climate of the southern pat of country. The incidence of multiple births was related to maternal age but did not bear any association to the climate or prevalence of malaria.

Adult↗
PubMed1996

Maternal risk of breast cancer following multiple births: a nationwide study in Sweden.

The association between multiple births and subsequent maternal breast cancer risk was explored in a nested case-control study in Sweden encompassing 19,368 parous women with breast cancer diagnosed up to age 65 years, and 100,459 parous controls. Among cases and controls, there were 329 and 2,031 women, respectively, with a history of at least one live multiple birth. Compared with singleton mothers, breast cancer risk was 12 percent lower (odds ratio = 0.88, 95 percent confidence interval = 0.78-0.99) in women who had had a multiple birth. After stratification for age at diagnosis, evidence of a significant inverse association was found only in women aged 54 years or younger. Birth order of the multiple pregnancy had no apparent risk-modifying effect. Age at earliest multiple birth was unrelated to breast cancer risk. The inverse association between twinning and breast cancer risk may reflect protective physiological features of twin pregnancies. Further research is needed to investigate the role, if any, of increased levels of steroid hormone-binding globulins in mothers of twins and the proposed inhibitory effects of human chorionic gonadotropin and alpha-fetoprotein, both of which are increased during multiple gestations, on breast carcinogenesis. Breast feeding patterns in mothers of twins also may modify their risk of developing breast cancer.

Adult↗
PubMed1996

Recent trends in the incidence of multiple births and associated mortality in England and Wales.

AIM: To review trends in multiple births and associated mortality in England and Wales since 1975, in the light of trends for earlier years; to assess, within the limitations of the available data, the extent of any association between multiple birth rates and assisted conception and drugs used for subfertility. METHODS: Data collected routinely in England and Wales, between 1975 and 1994, were retrospectively reviewed. These comprised Office of Population Censuses and Surveys (OPCS) data collected at the registration of live and stillbirths and deaths occurring under the age of 1 year in England and Wales from 1975 onwards. Department of Health data about NHS prescriptions dispensed outside hospitals within England for drugs which could be used in the medical management of subfertility were also included. RESULTS: The proportion of pregnancies that resulted in a registered multiple birth increased from a low of 9.9 per thousand in 1975 to 13.6 per thousand in 1994. Up to 1992, the increase was seen in all age groups except for women under 20, with the most substantial increase being in women aged 35 to 39. The rise in the rate of triplet and other higher order births was much steeper than that for all multiple births, increasing from 0.13 sets of triplets per thousand maternities in 1975, to 0.41 in 1994. Prescriptions dispensed for selected drugs that may be used for the medical management of subfertility and assisted conception became more common over this period. The fragmented nature of the data precluded direct comparison with changes in multiple birth rates, however. CONCLUSIONS: Although the causes of the rise since 1980 in multiple birth rates in general, and the dramatic rise in the triplet rate in particular, cannot be ascertained or quantified directly from routinely collected data, drugs used for subfertility and more recently, assisted conception, probably had a major role.

Adult↗
PubMed1992

Multiple births: trends and patterns in Canada, 1974-1990.

This paper examines Canadian trends and patterns in multiple births in relation to total confinements, singleton births, maternal age, parity, gestational age and birth weight using vital statistics from 1974 to 1990. Multiple-birth rates in Canada increased from 912.8 to 1,058.9 per 100,000 confinements between 1974 and 1990. The increase is especially noticeable for women over 30. The rate of triplet and higher-order births increased from 8.3 to 21.7 per 100,000 confinements between 1974 and 1990. The proportion of multiple-birth babies that were pre-term (< 37 weeks gestation period) increased from 32.8% in 1974 to 45.8% in 1990. Factors associated with the increase in multiple births may include the use of assisted pregnancy techniques, and the fact that women aged 30 and older, who are at higher risk of a multiple birth, and who postponed their child bearing, have increased their fertility. The sharp increase in multiple-birth rates has implications for maternal and child health and health care costs.

Adolescent↗