In the 1990s dramatic increases in the overall multiple births ratios (19%) and particularly higher order multiples (>400%) had a substantial impact on the US low birthweight (<2500 grams), very low birthweight (<1500 grams) and preterm (<37 weeks) delivery rates as well as an impact on birthweight specific infant mortality rates. For decades providers were taught that multiple births accounted for 2% of births but by 1997, 3% of live births were multiples, and multiples accounted for 13% of infant deaths. Despite overall increases in the US low birthweight (LBW) and preterm rates, stratification of these perinatal health indicators by plurality and race suggest that that LBW and preterm rates were actually stable or decreasing for singletons. Furthermore, for singleton white infants the 1997 LBW rate was 5%, consistent with the Year 2000 objective. But among multiple births, the rates of LBW and preterm increased for both white and black infants in the 1990s. Of particular interest is that the racial/ethnic disparities so well documented for other perinatal outcomes do not follow expected trends for multiple births. Results of racial, maternal age and regional specific analyses of trends by plurality for low and very low birthweight, preterm and birthweight-specific infant mortality rates will be presented and discussed. Implications for surveillance systems and realistic tracking of relevant Healthy People 2010 objectives will be reviewed.
Learning Objectives: At the conclusion of the session, participants in this session will be able to: 1. Describe trends in perinatal outcomes over the past 15 years. 2. Assess the impact of multiple, particularly higher order, births on infant morbidity and mortality. 3. Discuss the implications of the increase in multiple births for surveillance systems and tracking of Healthy People 2010 objectives
Keywords: Birth Outcomes, MCH Epidemiology
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.