Plurality and Contemporary Infant Mortality Risks

Summary

Principal Investigator: Barbara Luke
Affiliation: University of Miami
Country: USA
Abstract: In 2002 there were more than 132,000 infants born from multiple pregnancies in the US, the highest number ever recorded. Since 1980 this rate has risen dramatically, due primarily to infertility treatments in combination with the trend of childbearing at older ages. The use of assisted reproductive technologies carries a 30-50% risk of resulting in a multiple pregnancy, depending on the medications and techniques used. Older maternal age requires more aggressive therapies to achieve a pregnancy, including transferring more embryos. The two most important factors affecting perinatal mortality are gestational age and relative birth weight; with each additional fetus, both of these factors are compromised. Compared to singletons, infants of multiple pregnancies are much more likely to be born early preterm and very low birth weight, important factors contributing to their excess morbidity and mortality. We do not have contemporary, nationally representative, population-based estimates of the increased infant mortality risk associated with multiple pregnancies. The purpose of this proposed study is to determine the infant mortality risks for infants of multiple pregnancies, controlling for important maternal and fetal factors, including age, race and ethnicity, parity, smoking status, infant gender, birth weight, and gestational age, as well as factors unique to multiple pregnancies (e.g., weight discordance, gender mix, fetal death of a sibling). The central hypothesis of this proposal is that mortality risk is higher for infants of multiple pregnancies compared to singletons, and that some of this risk has been postponed from the neonatal to the post-neonatal period. The data for this study are the 1995-2000 Linked Birth/Infant Death Data Sets and the Matched Multiple Birth Data Sets. The resulting plurality-specific perinatal, neonatal, post-neonatal, and overall infant mortality risks will help practitioners counsel patients undergoing infertility treatments and considering multi-fetal pregnancy education, and more effectively manage the pre- and postnatal health of infants of multiple pregnancy.
Funding Period: 2004-12-01 - 2007-11-30
more information: NIH RePORT

Top Publications

  1. pmc The changing risk of infant mortality by gestation, plurality, and race: 1989-1991 versus 1999-2001
    Barbara Luke
    School of Nursing and Health Studies, University of Miami, 5801 Red Rd, Coral Gables, FL, USA
    Pediatrics 118:2488-97. 2006
  2. pmc Contemporary risks of maternal morbidity and adverse outcomes with increasing maternal age and plurality
    Barbara Luke
    University of Miami School of Nursing and Health Studies, Coral Gables, Florida 33143, USA
    Fertil Steril 88:283-93. 2007
  3. ncbi Elevated risks of pregnancy complications and adverse outcomes with increasing maternal age
    Barbara Luke
    University of Miami School of Nursing and Health Studies, Coral Gables, FL 33143, USA
    Hum Reprod 22:1264-72. 2007
  4. pmc The effect of plurality and gestation on the prevention or postponement of infant mortality: 1989-1991 versus 1999-2001
    Barbara Luke
    University of Miami School of Nursing and Health Studies, Coral Gables, Florida 33143, USA
    Twin Res Hum Genet 10:514-20. 2007
  5. pmc Maternal risk factors for potential maltreatment deaths among healthy singleton and twin infants
    Barbara Luke
    University of Miami School of Nursing and Health Studies, Coral Gables, Florida 33146, USA
    Twin Res Hum Genet 10:778-85. 2007
  6. doi Maternal morbidity and infant death in twin vs triplet and quadruplet pregnancies
    Barbara Luke
    University of Miami School of Nursing and Health Studies, Coral Gables, FL, USA
    Am J Obstet Gynecol 198:401.e1-10. 2008

Scientific Experts

Detail Information

Publications6

  1. pmc The changing risk of infant mortality by gestation, plurality, and race: 1989-1991 versus 1999-2001
    Barbara Luke
    School of Nursing and Health Studies, University of Miami, 5801 Red Rd, Coral Gables, FL, USA
    Pediatrics 118:2488-97. 2006
    ..Our aim was to quantify contemporary infant mortality risks and to evaluate the change by plurality, gestation, and race during the most recent decade...
  2. pmc Contemporary risks of maternal morbidity and adverse outcomes with increasing maternal age and plurality
    Barbara Luke
    University of Miami School of Nursing and Health Studies, Coral Gables, Florida 33143, USA
    Fertil Steril 88:283-93. 2007
    ..To evaluate the risks of pregnancy complications and adverse outcomes associated with increasing maternal age and higher plurality...
  3. ncbi Elevated risks of pregnancy complications and adverse outcomes with increasing maternal age
    Barbara Luke
    University of Miami School of Nursing and Health Studies, Coral Gables, FL 33143, USA
    Hum Reprod 22:1264-72. 2007
    ..The objective of this study was to evaluate the risks of pregnancy complications and adverse outcomes with increasing maternal age using national vital statistics data...
  4. pmc The effect of plurality and gestation on the prevention or postponement of infant mortality: 1989-1991 versus 1999-2001
    Barbara Luke
    University of Miami School of Nursing and Health Studies, Coral Gables, Florida 33143, USA
    Twin Res Hum Genet 10:514-20. 2007
    ..Infant mortality rates improved by 28% for singletons, 32% for twins and triplets during the 1990s, although for the most premature infants, some deaths were postponed from the early to the late neonatal period...
  5. pmc Maternal risk factors for potential maltreatment deaths among healthy singleton and twin infants
    Barbara Luke
    University of Miami School of Nursing and Health Studies, Coral Gables, Florida 33146, USA
    Twin Res Hum Genet 10:778-85. 2007
    ..These results add to the body of knowledge regarding risk factors for infant mortality among healthy singletons and twins...
  6. doi Maternal morbidity and infant death in twin vs triplet and quadruplet pregnancies
    Barbara Luke
    University of Miami School of Nursing and Health Studies, Coral Gables, FL, USA
    Am J Obstet Gynecol 198:401.e1-10. 2008
    ..The purpose of this study was to calculate nationally representative, population-based estimates of maternal and neonatal risks in triplet and quadruplet pregnancies compared with twin pregnancies...