multiple birth offspring


Summary: The offspring in multiple pregnancies (PREGNANCY, MULTIPLE): TWINS; TRIPLETS; QUADRUPLETS; QUINTUPLETS; etc.

Top Publications

  1. Wright V, Chang J, Jeng G, Chen M, Macaluso M. Assisted reproductive technology surveillance - United States, 2004. MMWR Surveill Summ. 2007;56:1-22 pubmed
    ..Adverse maternal and infant outcomes (e.g., low birthweight and preterm delivery) associated with ART treatment choices should be explained fully when counseling patients who are considering ART. ..
  2. Martin J, Hamilton B, Ventura S, Osterman M, Kirmeyer S, Mathews T, et al. Births: final data for 2009. Natl Vital Stat Rep. 2011;60:1-70 pubmed
    ..18 percent; the low birthweight rate was stable at 8.16 percent. The twin birth rate increased to 33.2 per 1,000; the triplet and higher-order multiple birth rate rose 4 percent to 153.5 per 100,000. ..
  3. Ooki S. Population-based database of multiples in childhood of Ishikawa Prefecture, Japan. Twin Res Hum Genet. 2006;9:832-7 pubmed
    ..This registry aims not only to aid research on human genetics and maternal and child health, but also to contribute to the development of welfare programs for families with multiples. ..
  4. Wright V, Chang J, Jeng G, Macaluso M. Assisted reproductive technology surveillance--United States, 2003. MMWR Surveill Summ. 2006;55:1-22 pubmed
    ..In addition, adverse infant health outcomes (e.g., low birthweight and preterm delivery) should be considered when assessing the efficacy and safety of ART. ..
  5. Leonard L, Denton J. Preparation for parenting multiple birth children. Early Hum Dev. 2006;82:371-8 pubmed
  6. Dickey R. The relative contribution of assisted reproductive technologies and ovulation induction to multiple births in the United States 5 years after the Society for Assisted Reproductive Technology/American Society for Reproductive Medicine recommendation t. Fertil Steril. 2007;88:1554-61 pubmed
    ..S. HOMB did not decrease due to a 67% increase in total ART births and an increase in triplet births from OI. ..
  7. Martin J, Hamilton B, Sutton P, Ventura S, Mathews T, Kirmeyer S, et al. Births: final data for 2007. Natl Vital Stat Rep. 2010;58:1-85 pubmed
    ..Preliminary findings for 2008 suggest that these trends continued for cesarean delivery, unmarried childbearing, and preterm births. ..
  8. Magee B. Role of multiple births in very low birth weight and infant mortality. J Reprod Med. 2004;49:812-6 pubmed
    ..quot; Over 30% of VLBW infants, nearly 20% of infant mortality and >30% of infant mortality due to perinatal conditions could be attributed to multiples. Multiple pregnancy is a significant public health problem. ..
  9. Blondel B, Kaminski M. [The increase in multiple births and its consequences on perinatal health]. J Gynecol Obstet Biol Reprod (Paris). 2002;31:725-40 pubmed
    ..1% in 1995-97. These results suggest that research and preventive interventions should not be restricted to triplets, but should also include twins. ..

More Information


  1. Schieve L, Devine O, Boyle C, Petrini J, Warner L. Estimation of the contribution of non-assisted reproductive technology ovulation stimulation fertility treatments to US singleton and multiple births. Am J Epidemiol. 2009;170:1396-407 pubmed publisher
    ..On the basis of the model, the authors estimate that 4.6% of US infants born in 2005 (95% uncertainty range: 2.8%-7.1%) resulted from non-ART ovulation treatments. Notably, this figure is 4 times greater than the ART contribution. ..
  2. Hibbs A, Black D, Palermo L, Cnaan A, Luan X, Truog W, et al. Accounting for multiple births in neonatal and perinatal trials: systematic review and case study. J Pediatr. 2010;156:202-8 pubmed publisher
    ..The statistical approach to multiples can influence the odds ratio and width of confidence intervals, thereby affecting the interpretation of a study outcome. A minority of perinatal studies address this issue. ..
  3. Fuster V, Zuluaga P, Colantonio S, de Blas C. Factors associated with recent increase of multiple births in Spain. Twin Res Hum Genet. 2008;11:70-6 pubmed publisher
    ..A modified logistic curve predicts a stabilization of multiple deliveries, which will probably continue to be high in Spain. ..
  4. Ooki S. The effect of an increase in the rate of multiple births on low-birth-weight and preterm deliveries during 1975-2008. J Epidemiol. 2010;20:480-8 pubmed
    ..The population attributable risk percent tended to increase during the same period for all variables, and was approximately 20% in 2008. The public health impact of the rapid increase in multiple births remains high in Japan. ..
  5. Puumala S, Carozza S, Chow E, Fox E, Horel S, Johnson K, et al. Childhood cancer among twins and higher order multiples. Cancer Epidemiol Biomarkers Prev. 2009;18:162-8 pubmed publisher
    ..Our analysis suggests that mechanisms other than birth weight and gestational age may influence the lower risk of Wilms' tumor and neuroblastoma in multiple births. ..
  6. Gunby J, Bissonnette F, Librach C, Cowan L. Assisted reproductive technologies (ART) in Canada: 2004 results from the Canadian ART Register. Fertil Steril. 2008;89:1123-32 pubmed
    ..Clinical pregnancy and live birth rates were higher and multiple birth rates were lower in 2004 than in previous years. ..
  7. Uthman O, Uthman M, Yahaya I. A population-based study of effect of multiple birth on infant mortality in Nigeria. BMC Pregnancy Childbirth. 2008;8:41 pubmed publisher
    ..A well-educated mother has a better chance of satisfying important factors that can improve infant survival: the quality of infant feeding, general care, household sanitation, and adequate use of preventive and curative health services. ..
  8. Sunderam S, Chang J, Flowers L, Kulkarni A, Sentelle G, Jeng G, et al. Assisted reproductive technology surveillance--United States, 2006. MMWR Surveill Summ. 2009;58:1-25 pubmed
    ..Adverse maternal and infant outcomes (e.g., low birthweight and preterm delivery) associated with ART treatment choices should be explained thoroughly when counseling patients considering ART. ..
  9. Norwitz E, Edusa V, Park J. Maternal physiology and complications of multiple pregnancy. Semin Perinatol. 2005;29:338-48 pubmed
    ..This article reviews in detail the maternal physiologic adaptations required to support a multiple pregnancy and the maternal complications that develop when these systems fail or are overwhelmed. ..
  10. Glinianaia S, Rankin J, Wright C, Sturgiss S, Renwick M. A multiple pregnancy register in the north of England. Twin Res. 2002;5:436-9 pubmed
    ..6 per 1000 livebirths respectively. A prospective Multiple Pregnancy Register not only allows monitoring of trends in multiple birth rates and mortality, but also etiological research and long-term follow-up studies. ..
  11. Ward Platt M, Glinianaia S, Rankin J, Wright C, Renwick M. The North of England Multiple Pregnancy Register: five-year results of data collection. Twin Res Hum Genet. 2006;9:913-8 pubmed
    ..The register is an important resource of data on multiple pregnancies, which allows monitoring of trends in multiple birth rates and pregnancy losses and provides a unique opportunity for etiological and long-term follow-up studies. ..
  12. Cook J, Collins J, Buckett W, Racowsky C, Hughes E, Jarvi K. Assisted reproductive technology-related multiple births: Canada in an international context. J Obstet Gynaecol Can. 2011;33:159-167 pubmed publisher
    ..In order effectively to reduce the multiple-birth rate in Canada, it is important to learn from the experiences of other countries, taking the Canadian context into consideration. ..
  13. Hong R. Effect of multiple birth on infant mortality in Bangladesh. J Paediatr Child Health. 2006;42:630-5 pubmed
  14. Denton J. Twins and more--2. Practical aspects of parenting in the early years. J Fam Health Care. 2005;15:173-6 pubmed
    ..Bereavement counselling and support may also be required, as the mortality rate is higher for multiple births. Part Two looks at the care commonly needed for multiple birth families during the first five years. ..
  15. Wright V, Chang J, Jeng G, Macaluso M. Assisted reproductive technology surveillance--United States, 2005. MMWR Surveill Summ. 2008;57:1-23 pubmed
    ..Adverse maternal and infant outcomes (e.g., low birthweight and preterm delivery) associated with ART treatment choices should be explained fully when counseling patients who are considering ART. ..
  16. Loi K, Prasath E, Huang Z, Loh S, Loh S. A cumulative embryo scoring system for the prediction of pregnancy outcome following intracytoplasmic sperm injection. Singapore Med J. 2008;49:221-7 pubmed
    ..CES based on the proposed five-point scoring system is useful for the prediction of pregnancy outcome in triple embryo transfers. In younger patients, a policy of transferring fewer embryos to reduce multiple births should be adopted. ..
  17. Ren Y, Wang Q, Shi L, Yue W, Zhang C, Lei F. Effects of maternal and dietary selenium (Se-enriched yeast) on the expression of p34(cdc2) and CyclinB1 of germ cells of their offspring in goats. Anim Reprod Sci. 2011;123:187-91 pubmed publisher
    ..In addition, Se deficiency and Se excess could prevent the completion of the cell cycle. ..
  18. Imaizumi Y. Constant multiple birth rates in the Czech Republic and the Slovak Republic until recently, 1972-1995. Twin Res. 1999;2:10-5 pubmed
    ..The corresponding values were 2.7, 2.20 and 5.9-fold in the Slovak Republic. Both the Czech and the Slovak Republics were not affected by fertility drugs and assisted reproductive techniques until recently. ..
  19. Malcolm W, Hornik C, Evans A, Smith P, Cotten C. Vocal fold paralysis following surgical ductal closure in extremely low birth weight infants: a case series of feeding and respiratory complications. J Perinatol. 2008;28:782-5 pubmed publisher
    ..The case series suggests that some long-term morbidities associated with surgical closure of the PDA may be attributable to this specific complication. ..
  20. Fellman J, Eriksson A. Secondary sex ratio in multiple births. Twin Res Hum Genet. 2010;13:101-8 pubmed publisher
    ..For triplets, the sex ratio showed large random fluctuations and was on average low. During the period 1901-1967, 20 quadruplet, two quintuplet and one sextuplet set were registered. The sex ratio was low, around 92.0. ..
  21. Borahay M, Phelps J. Potential liability of reproductive endocrinologists for high order multiple gestation. J Assist Reprod Genet. 2010;27:157-9 pubmed publisher
    ..In situations in which the number of embryos transferred is in excess of the ASRM guidelines, justification for deviating from the ASRM guidelines should be justifiable and documented in the medical records. ..
  22. Segal N. Personality and birth order in monozygotic twins adopted apart: a test of Sulloway's theory; Research Reviews: twin births and cancer risk in mothers, male sexual dysfunction, twin study of ultimatum game behavior; Human Interest: 'The Land of Twins'. Twin Res Hum Genet. 2008;11:103-7 pubmed publisher
    ..This article concludes with a discussion of twinning rates and rituals among the Yoruba of western Nigeria, and descriptions of two unusual reunions between siblings and twins. ..
  23. Yelland L, Salter A, Ryan P, Makrides M. Analysis of binary outcomes from randomised trials including multiple births: when should clustering be taken into account?. Paediatr Perinat Epidemiol. 2011;25:283-97 pubmed publisher
    ..We recommend using a method which takes the clustering into account when analysing datasets including infants from multiple births. ..
  24. Pharoah P. Fetal death registration in multiple births: anomalies and clinical significance. Twin Res Hum Genet. 2006;9:587-90 pubmed
    ..Legal definition for the registration of fetal death requires international agreement and application. ..
  25. Nakhuda G, Sauer M. Addressing the growing problem of multiple gestations created by assisted reproductive therapies. Semin Perinatol. 2005;29:355-62 pubmed
    ..Further reduction in the incidence of multiple births after ART necessitates a redefinition of success to emphasize the healthy singleton birth rate, rather than crude pregnancy rates. ..
  26. Schjølberg S, Eadie P, Zachrisson H, Oyen A, Prior M. Predicting language development at age 18 months: data from the Norwegian Mother and Child Cohort Study. J Dev Behav Pediatr. 2011;32:375-83 pubmed publisher
    ..Despite this finding, most of the variability in language performance in this cohort of 18 month olds remained unexplained by the comprehensive set of purported risk factors. ..
  27. Bernis C, Varea C. Hour of birth and birth assistance: from a primate to a medicalized pattern?. Am J Hum Biol. 2012;24:14-21 pubmed publisher
    ..Possible consequences of diurnal birth include reduced infant-mother bonding, breast feeding, and later life reductions to health. ..
  28. Guzoglu N, Kanmaz H, Dilli D, Uras N, Erdeve O, Dilmen U. The impact of the new Turkish regulation, imposing single embryo transfer after assisted reproduction technology, on neonatal intensive care unit utilization: a single center experience. Hum Reprod. 2012;27:2384-8 pubmed publisher
    ..However, multicenter studies are needed to generalize our results to the whole country. ..
  29. Gerris J, De Neubourg D, De Sutter P, Van Royen E, Mangelschots K, Vercruyssen M. Cryopreservation as a tool to reduce multiple birth. Reprod Biomed Online. 2003;7:286-94 pubmed
    ..In the future, the combination of elective single-embryo transfer with an optimized cryopreservation programme is likely to become the standard of care for routine IVF/ICSI treatment. ..
  30. Ellison M, Hall J. Social stigma and compounded losses: quality-of-life issues for multiple-birth families. Fertil Steril. 2003;80:405-14 pubmed
    ..These findings are significant, given that at least 38% of all assisted conceptions result in a multiple birth. This study lays the groundwork for further research on the impact of iatrogenic multiple births. ..
  31. Charles S, Shivas T. Mothers in the media: blamed and celebrated--an examination of drug abuse and multiple births. Pediatr Nurs. 2002;28:142-5 pubmed
    ..In conclusion, the communal and regulatory responses to both drug-addicted pregnant women and large multiple births caused by infertility treatments needs to be rethought. ..
  32. Rong Z, Liu H, Xia S, Chang L. Risk and protective factors of intraventricular hemorrhage in preterm babies in Wuhan, China. Childs Nerv Syst. 2012;28:2077-84 pubmed publisher
    ..In the present study, factors that related to neonatal IVH included hypotension, prenatal steroid use, and transportation. ..
  33. Olamijulo J, Olaleye O. Perinatal mortality in Lagos University Teaching Hospital: a five year review. Nig Q J Hosp Med. 2011;21:255-61 pubmed
    ..The causes of perinatal death are largely preventable. Urgent clinical and political actions are required to make any progress towards attaining the fourth millennium development goal (MDG4). ..
  34. Yokoyama Y, Murai C, Miyashita A, Tatsumi T, Fujioka H. [Breast-feeding and the mother's sentiment towards child rearing. Analysis of database on health checkups]. Nihon Koshu Eisei Zasshi. 2012;59:771-80 pubmed
    ..These feeding methods were associated with multiple births, birth weight, maternal smoking status during pregnancy, and maternal age at delivery. ..
  35. Kwok M, Au Yeung S, Leung G, Schooling C. Birth weight and adult cardiovascular risk factors using multiple birth status as an instrumental variable in the 1958 British Birth Cohort. Prev Med. 2016;84:69-75 pubmed publisher
    ..Such analysis suggests that birth weight may be spuriously related to height, BMI and blood pressure, and thus not an effective target for intervention. ..
  36. Stern J, Goldman M, Hatasaka H, MacKenzie T, Surrey E, Racowsky C. Optimizing the number of cleavage stage embryos to transfer on day 3 in women 38 years of age and older: a Society for Assisted Reproductive Technology database study. Fertil Steril. 2009;91:767-76 pubmed publisher
    ..To determine the optimal number of day 3 embryos to transfer in women >or=38 years by conducting an evidence-based evaluation...
  37. Jenkins J, McCall E, Gardner E, Casson K, Dolk H. Socioeconomic inequalities in neonatal intensive care admission rates. Arch Dis Child Fetal Neonatal Ed. 2009;94:F423-8 pubmed publisher
    ..Efforts to achieve targets for reduction in infant mortality need to take account of the different effects of socioeconomic inequalities for different conditions and groups of infants. ..
  38. Ballantyne C. One egg is best. Nat Med. 2008;14:793 pubmed publisher
  39. Tyrala E, Chung E. Cobedding twins and higher-order multiples. Pediatrics. 2008;121:1073; author reply 1073-4 pubmed publisher
  40. Vaag A, Poulsen P. Periconceptional nutrition, twinning and how this impacts on current understanding of the aetiology and pathophysiology of the metabolic syndrome. J Physiol. 2008;586:1203-4 pubmed publisher
  41. Lieberman B, Ali R, Rangarajan S. Towards the elective replacement of a single embryo (eSET) in the United Kingdom. Hum Fertil (Camb). 2007;10:123-7 pubmed
    ..The elective transfer of a single fresh embryo, followed if necessary by a single thawed embryo, in women at high risk of a multiple birth does not reduce the live birth rate and all but prevents the conception of twins and triplets. ..
  42. Cleary Goldman J, D Alton M, Berkowitz R. Prenatal diagnosis and multiple pregnancy. Semin Perinatol. 2005;29:312-20 pubmed
    ..The following paper will review the unique concerns associated with prenatal diagnosis in a multiple pregnancy and the current methods of prenatal screening in these patients. Invasive prenatal diagnosis will also be explored. ..
  43. Choi S, Park Y, Shim K, Choi Y, Chang J, Hahn W, et al. Recent trends in the incidence of multiple births and its consequences on perinatal problems in Korea. J Korean Med Sci. 2010;25:1191-6 pubmed publisher
    ..3% and 51.5% during the same years. The incidence of multiple births and its consequences on perinatal problems (preterm, LBWI, and advanced-maternal age) have been increased steadily over the last two decades in Korea. ..
  44. Li S, Ford N, Meister K, Bodurtha J. Increased risk of birth defects among children from multiple births. Birth Defects Res A Clin Mol Teratol. 2003;67:879-85 pubmed
    ..A higher fatality and mortality rate and longer hospital stay were also observed. Overall, children from multiple births have an increased risk of birth defects. ..
  45. Gurgan T, Demirol A. Why and how should multiple pregnancies be prevented in assisted reproduction treatment programmes?. Reprod Biomed Online. 2004;9:237-44 pubmed
    ..Laboratory expertise is of vital importance, especially in terms of embryo culture, embryo selection, and freezing and thawing techniques in embryo transfer programmes for reducing the number of transferred embryos. ..
  46. Silva A, Lamy Filho F, Alves M, Coimbra L, Bettiol H, Barbieri M. Risk factors for low birthweight in north-east Brazil: the role of caesarean section. Paediatr Perinat Epidemiol. 2001;15:257-64 pubmed
    ..Because it appears unlikely that only medical reasons are operative, it is a possibility that CS could cause LBW, reflecting abusive indications for elective CS. ..
  47. Weber D, Stuetz W, Bernhard W, Franz A, Raith M, Grune T, et al. 5-Methyltetrahydrofolate and thiamine diphosphate in cord-blood erythrocytes of preterm versus term newborns. Eur J Clin Nutr. 2013;67:1029-35 pubmed publisher
    ..Future studies evaluating cord-blood vitamin concentrations and their associations with birth outcomes should additionally include dietary intakes and maternal blood concentrations at different stages of pregnancy. ..
  48. MacDorman M, Minino A, Strobino D, Guyer B. Annual summary of vital statistics--2001. Pediatrics. 2002;110:1037-52 pubmed
    ..Among unintentional injuries to children, two-thirds were motor vehicle-related; among homicides, two-thirds were firearm-related. ..
  49. Vallino Napoli L, Riley M, Halliday J. An epidemiologic study of isolated cleft lip, palate, or both in Victoria, Australia from 1983 to 2000. Cleft Palate Craniofac J. 2004;41:185-94 pubmed
    ..Further studies focusing on certain ethnic groups are warranted to explain the higher rates observed. ..
  50. Lau C, Hurst N, Bums P, Schanler R. Interaction of stress and lactation differs between mothers of premature singletons and multiples. Adv Exp Med Biol. 2004;554:313-6 pubmed
  51. Biro M, Davey M, Carolan M, Kealy M. Advanced maternal age and obstetric morbidity for women giving birth in Victoria, Australia: A population-based study. Aust N Z J Obstet Gynaecol. 2012;52:229-34 pubmed publisher
    ..Delayed childbearing for an increasing number of women has societal and public health ramifications and will potentially place greater demand on healthcare services. ..
  52. Marlow N, Pike K, Bower E, Brocklehurst P, Jones D, Kenyon S, et al. Characteristics of children with cerebral palsy in the ORACLE children study. Dev Med Child Neurol. 2012;54:640-6 pubmed publisher
    ..However, in these groups the risk of CP was increased independently of gestational age. This is consistent with findings that ongoing inflammatory damage can cause CP. ..
  53. Elliott J. High-order multiple gestations. Semin Perinatol. 2005;29:305-11 pubmed
    ..Fetal fibronectin testing helps predict risk of PTL, and magnesium sulfate tocolysis is used in aggressive dosing to arrest PTL if it occurs. Outcomes are presented and discussed. Successful outcomes are not only possible, but probable. ..