Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Multiple Birth”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,279 records · Page 71Linked to original sources
PubMed2006

Estimation of optimal birth weights and gestational ages for twin births in Japan.

BACKGROUND: As multiple pregnancies show a higher incidence of complications than singletons and carry a higher perinatal risk, the calculation of birth weight - and gestational age (GA)-specific perinatal mortality rates (PMR) for multiple births is necessary in order to estimate the lowest PMR for these groups. METHODS: Details of all reported twins (192,987 live births, 5,539 stillbirths and 1,830 early neonatal deaths) in Japan between 1990 and 1999 were analyzed and compared with singletons (10,021,275 live births, 63,972 fetal deaths and 16,862 early neonatal deaths) in the annual report of vital statistics of Japan. The fetal death rate (FDR) and PMR were calculated for each category of birth weight at 500-gram intervals and GA at four-week intervals. The FDR according to birth weight and GA category was calculated as fetal deaths/(fetal deaths + live births) x 1000. The perinatal mortality rate (PMR) according to birth weight and GA category, was calculated as (fetal deaths + early neonatal deaths)/(fetal deaths + live births) x 1000. Within each category, the lowest FDR and PMR were assigned with a relative risk (RR) of 1.0 as a reference and all other rates within each category were compared to this lowest rate. RESULTS: The overall PMR per 1,000 births for singletons was 6.9, and the lowest PMR was 1.1 for birth weight (3.5-4.0 kg) and GA (40-weeks). For twins, the overall PMR per 1,000 births was 36.8, and the lowest PMR was 3.9 for birth weight (2.5-3.0 kg) and GA (36-39 weeks). At optimal birth weight and GA, the PMR was reduced to 15.9 percent for singletons, and 10.6 percent for twins, compared to the overall PMR. The risk of perinatal mortality was greater in twins than in singletons at the same deviation from the ideal category of each plurality. CONCLUSION: PMRs are potentially reduced by attaining the ideal birth weight and GA. More than 90 percent of mortality could be reduced by attaining the optimal GA and birth weight in twins by taking particular care to ensure appropriate pregnancy weight gain, as well as adequate control for obstetric complications.

Birth Weight↗
PubMed1992

Low birth weight in relation to multiple induced abortions.

BACKGROUND: Most studies report that a single induced abortion does not increase risk for delivering a low birth weight infant in a subsequent pregnancy. However, the effect of multiple abortions has not been adequately evaluated. METHODS: This relationship was studied in 6541 White women who delivered their first child between 1984 and 1987. We compared the frequencies of low birth weight (less than 2500 g) among infants born to 1999 women without prior induced abortion and 1999 women with one abortion with the frequencies of low birth weight among infants born to women with two (n = 1850), three (n = 520), and four or more (n = 173) prior induced abortions. RESULTS: After adjustment for confounding variables, we found no linear relationship in risk of low birth weight among women with one (relative risk [RR] = 1.2, 95% confidence interval [CI] = 0.9-1.5), two (RR = 1.5, 95% CI = 1.1-2.0), three (RR = 1.3, 95% CI = 0.8-1.9), or four or more (RR = 1.6, 95% CI = 0.9-2.9) prior induced abortions. CONCLUSIONS: These findings confirm earlier reports of little or no evidence of harmful effects on birth weight by one or by two or more induced abortions. We further report that risk is not significantly elevated even in women with three, four, or more prior terminations of pregnancy when compared with women with one or two abortions.

Abortion, Induced↗
PubMed2003

Cerebral palsy rates among low-birthweight infants fell in the 1990s.

Using a population-based register, this study sought to ascertain changes in the rate and severity of cerebral palsy (CP) in a geographically defined area of the UK among infants weighing less than 1500 g and born between 1984 and 1995. There were 417414 live births in the area, which included Berkshire, Buckinghamshire, Northamptonshire, and Oxfordshire. Of the 898 children with CP (526 males, 372 females), 194 (21.6%) weighed less than 1500 g at birth. The overall CP rate for neonatal survivors fell from 2.5 out of every 1000 in 1984 to 1986 to 1.7 in 1993 to 1995. The rate for those weighing less than 1000 g rose to 90 out of every 1000 neonatal survivors in 1987 to 1989 and then fell to 57 in 1993 to 1995. A similar pattern is seen among infants weighing 1000 to 1499 g at birth, the rate rising to 77 in 1987 to 1988 and then falling to 40 in 1993 to 1995. The rate of severe motor disability among infants weighing less than 1500 g also decreased (24.6 in 1984-1986 to 12.5 in 1993-1995). The relation of these findings to changes in perinatal care in the early 1990s is not known.

Cerebral Palsy↗
PubMed1979

An epidemiological study of cerebral palsy in Western Australia, 1956-1975. I: Changes in total incidence of cerebral palsy and associated factors.

Patterns in the incidence of cerebral palsy are described over a 20-year period in Western Australia. The incidence rose to a peak between 1966 and 1970, then fell again. This pattern was particularly marked in the spastic syndromes and was seen in both sexes, in each maternal age and parity group, in each IQ group, in both multiple and single births, and in infants born in metropolitan (but not rural) areas. Improvement was more marked in heavier than in lighter infants. Since 1968 the male rate has fallen more quickly than that for females. The risk of cerebral palsy with high maternal age declined, but it remained high in relation to high parities. There were marked reductions in the proportions of older and higher-parity mothers in Western Australia over the study period, and in the proportion of multiple births. There was also a shift toward heavier babies from 1968 to 1975. Social-class information was not available. The data indicate that factors in addition to changes in perinatal care were operating to improve neonatal outcome in terms of long-term handicap in Western Australia.

Adult↗
PubMed2005

Very preterm birth is associated with disabilities in multiple developmental domains.

OBJECTIVE: Follow-up studies in very preterm children usually present outcome for separate developmental domains. Presence of disabilities in more than one developmental domain will show a more serious outcome picture for extreme preterm infants and may be related to a different degree of perinatal problems. METHODS: At 5.5 years corrected age, outcome in the neurological, motor, cognitive, and behavioral domain was studied in 157 children born < 30 weeks gestation. The children were divided into a normal, a single, or a multiple disability group. Group differences in background, clinical characteristics, and neurodevelopmental outcome at 2 years were evaluated. RESULTS: Thirty-nine percent had a normal developmental outcome, 17% had a single disability, and 44% had multiple disabilities. Multiple disabilities were associated with lower birth weight, BPD, and difficulties according to neurodevelopmental assessments at 2 years. CONCLUSION: Assessments of different developmental domains show that most very preterm children had multiple disabilities.

Achievement↗
PubMed2002

Low birth weight is associated with elevated serum lipoprotein(a) in white and black American children ages 5-11 y.

Nutritional insults experienced by the mother have a life-long imprint on organ size and function of the fetus. Infant low birth weight (LBW) is one of the consequences of such maternal undernutrition. The physiological consequences of nutritional insults can lead to adverse metabolic consequences after birth, including hypertension, diabetes and dyslipidemia. The objective of this study was to determine the association and contribution of LBW to serum concentration of lipoprotein(a) [Lp(a)] in a representative sample of white and black American children aged 5-11 y. Data (n=666) from the Third US National Health and Nutrition Examination Survey were used in this investigation. Racial/ethnic-specific trends in mean values of Lp(a) were compared across tertile distribution of birth weight. Multiple linear regression analysis was employed to determine the association of birth weight with Lp(a), controlling for age, sex and sum of four skinfold thicknesses (SUM). A consistent trend of increasing values of Lp(a) with decreasing birth weight emerged for both white and black children (P<0.001). Black children presented with higher values of serum concentrations of Lp(a) at each level of birth weight distributions than white children (P<0.01). Black race/ethnicity was associated with approximately 0.4 mg/dl greater serum concentration of Lp(a) than white, adjusting for birth weight, age, sex and SUM (P<0.001). LBW sub-population in black children appeared to be relevant to elevated Lp(a) concentration, while a similar scenario did not appear in white children. Since interactions between in utero factors and risk exposures after birth are likely, definitive studies evaluating these interactions are warranted.

Black or African American↗
PubMed1985

Multiple eruptive verrucous hemangiomas: a variant of multiple hemangiomatosis.

We present a case of an 8-year-old girl, who has, since birth, developed multiple angiomatous lesions of the skin. The evolution has been progressive and eruptive, with the lesions, beginning as reddish papulae, acquiring later a verrucous appearance. The case has revealed no associated systemic symptoms nor relevant family history of any interest. The clinical picture suggests multiple hemangiomatosis. The histopathology seems to relate this disorder to verrucous hemangioma, and therefore needs to be differentiated from angiokeratotic nevi. To our knowledge, reports of a similar clinicopathological picture are not mentioned in the literature.

Child↗
PubMed1997

Triplet births: trends and outcomes, 1971-94.

OBJECTIVES: This report describes changes in the number and ratio of live births in triplet and other higher order multiple deliveries from 1971 to 1994 by maternal race, age, education, and marital status. The report also examines the birth outcomes of triplets compared with singletons, including overall gestation specific, and birthweight specific infant mortality rates. METHODS: Birth data are obtained from the U.S. certificates of live birth. Mortality data were obtained from the Linked Birth and Infant Death Data Sets for the 1983-91 birth cohorts. Most analyses are based on triplet and other higher-order multiple births (quadruplet and quintuplet and greater births) in the aggregate. (Triplet births comprise about 92 percent of all higher order multiple births.) Triplet and other higher order birth ratios for most variables are computed by combining data for years 1982-84 and 1992-94, and for infant mortality by combining birth cohorts for years 1987-91. FINDINGS: Between 1971 and 1994 the number and ratio of triplet births quadrupled, rising from 1,034 to 4,594, and from 29.1 to 116.2 per 100,000 live births. Most of the increase was among births to white mothers, particularly among married and more educated mothers. Only about one-third of the increase in triplet birthing among white mothers between 1989 and 1994 could be attributed to changes in the maternal age distribution. Massachusetts reported the highest triplet birth ratio (215.9), more than twice the U.S. ratio (105.5). Other States with comparatively high ratios were New Hampshire, New Jersey, and Iowa. Nine of 10 triplets were born preterm compared with 1 of 10 singletons. The average triplet weighed 1,698 grams at birth, one-half that of the average singleton (3,358 grams). Triplets were about 12 times more likely to die during the first year of life as singletons, but had a survival advantage over singletons at lower gestations and birthweights.

Adult↗
PubMed1975

[A decrease in twin births and factors involved in multiple pregnancy].

The object of this investigation were the causes of the decrease of the frequency of twin births during the last two decades. In Moscow this frequency decreased from 1,19% in 1956 to 0,7% in 1973. Among the births the proportion of first births was observed to increase, as well as the proportion of very young mothers. The effect of this process on the women characterized by a tendency to polyembryony was more conspicuous, than in the average on the population as a whole. During the last decades the process of acceleration of puberty was observed both in the mothers of twins and in all the women in general. However a somewhat later onset of first menstruations is characteristic of the women having a tendency to polyembryony-Hormonal changes taking place in the course of acceleration are apparently one of the causes of the decrease of the twin births frequency.

Adolescent↗
PubMed2001

Risk factors for low birthweight in north-east Brazil: the role of caesarean section.

Caesarean section (CS) delivery is associated with low birthweight (LBW) in south-east Brazil. A hospital-based study was conducted on singleton infants from mothers residing in São Luís, to assess if an association between CS and LBW was found in the northern part of the country, where the CS rate is lower than in the south-east. A standardised questionnaire was administered to a sample of 2541 mothers in 10 hospitals, representing 94% of all deliveries, from March 1997 to February 1998. In a logistic model, type of delivery was the independent variable, the other variables were treated as confounders, and interaction terms were added between type of delivery and all other factors. LBW was associated with low maternal height, maternal smoking, primiparity, previous LBW, public insurance, preterm birth and CS. The CS rate was 33.7%. The risk of CS was higher for primiparous and married mothers, those with high level of schooling and attended by the same physician during prenatal and delivery care, deliveries held in private hospitals, daylight hours or evenings, and for those mothers who had adequate prenatal care. 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.

Adult↗
PubMed2001

The Preterm Prediction Study: toward a multiple-marker test for spontaneous preterm birth.

OBJECTIVE: The Preterm Prediction Study evaluated 28 potential biologic markers for spontaneous preterm birth in asymptomatic women at 23 to 24 weeks gestational age. This analysis compares those markers individually and in combination for an association with spontaneous preterm birth at <32 and <35 weeks gestational age. STUDY DESIGN: With the use of a nested case-control design from an original cohort study of 2929 women, results of tests from 50 women with a spontaneous preterm birth at <32 weeks and 127 women with a spontaneous preterm birth at <35 weeks were compared with results from matched-term control subjects. RESULTS: In the univariate analysis, the most potent markers that are associated with spontaneous preterm birth at <32 weeks by odds ratio were a positive cervical-vaginal fetal fibronectin test (odds ratio, 32.7) and <10th percentile cervical length (odds ratio, 5.8), and in serum, >90th percentiles of alpha-fetoprotein (odds ratio, 8.3) and alkaline phosphatase (odds ratio, 6.8), and >75th percentile of granulocyte colony-stimulating factor (odds ratio, 5.5). Results for spontaneous preterm birth at <35 weeks were generally similar but not as strong. Univariate and multivariate logistic regression analyses demonstrated little interaction among the tests in their association with spontaneous preterm birth. Combinations of the 5 markers were evaluated for their association with <32 weeks spontaneous preterm birth. Ninety-three percent of case patients had at least 1 positive test result versus 34% of control subjects (odds ratio, 24.0; 95% CI, 6.4-93.4). Among the case patients, 59% had >or=2 positive test results versus 2.4% of control subjects (odds ratio, 56.5; 95% CI, 7.1-451.7). If a cutoff of 3 positive test results was used, 20% of case patients and none of the control subjects had positive test results (P < .002). With the use of only the 3 serum tests (alkaline phosphatase, alpha-fetoprotein, and granulocyte colony-stimulating factor), any positive test identified 81% of cases versus 22% of control subjects (odds ratio, 14.7; 95% CI, 5.0-42.7). For spontaneous preterm birth at <35 weeks gestation, any 2 positive tests identified 43% of cases and 6% of control subjects (odds ratio, 11.2; 95% CI, 4.8-26.2). CONCLUSION: Overlap among the strongest biologic markers for spontaneous preterm birth is small. This suggests that the use of tests such as maternal serum alpha-fetoprotein, alkaline phosphatase, and granulocyte colony-stimulating factor as a group or adding their results to fetal fibronectin test and cervical length test results may enhance our ability to predict spontaneous preterm birth and that the development of a multiple-marker test for spontaneous preterm birth is feasible.

Alkaline Phosphatase↗
PubMed1989

Conceptive delays of twin-prone mothers: a demographic epidemiologic approach.

We studied the time interval to the first birth and to the twin birth using statistical and mathematical models in two groups of mothers, those with twins and those with singletons, from the same population. We made use of a pair-matched case-control design. We treated the maternal birth cohort and parity as confounders and thus as controlled. We also investigated the sex of twin pairs as an interactive variable, employing such methods as survival curve testing and using geometric, gamma, and exponential distributions where appropriate. The expectations derived from the mathematical models yield numerical estimates of fertility components. The results suggest that unlike-sex twin-prone mothers have higher fecundity than controls when they conceive singletons. Further, fecundity appears high and unimpaired before the birth of twins. Mothers of like-sex twins experience somewhat shorter and but more variable birth intervals than corresponding controls before the birth of twins, suggesting within-group heterogeneity. Specifically, the birth of like-sex twins is preceded by low fecundity and a short period of postpartum amenorrhea. Biologically, like-sex (presumably monozygotic) twin-prone mothers have a hormonal defect related eventually to menopausal status that interferes with ovulation and perhaps with lactation. As for unlike-sex twin-bearing mothers, they probably experience a displacement of their maximum fertility potential toward early reproductive life and an extension of their menstrual life. From a methodologic standpoint, the study of the fertility of twin-prone mothers cannot proceed without estimates of the fertility components of birth intervals, as these intervals do not lend themselves to straightforward analytical interpretations by statistical analyses.

Adult↗
PubMed2005

Epidemiologic characteristics of anophthalmia and bilateral microphthalmia among 2.5 million births in California, 1989-1997.

There is a paucity of epidemiologic information about the eye malformations anophthalmia and microphthalmia. Using data from a large population-based registry, we explored prevalences and maternal/infant characteristics associated with anophthalmia and bilateral microphthalmia. Data were derived from the California Birth Defects Monitoring Program, a population-based active surveillance system for collecting information on infants and fetuses with congenital malformations using multiple source ascertainment. Approximately 2.5 million births (liveborn and stillborn) occurred during the ascertainment period, 1989-1997. Information on maternal and infant/fetal characteristics was obtained from California birth certificate and fetal death files. The prevalence per 10,000 livebirths and stillbirths for anophthalmia was 0.18 and for bilateral microphthalmia was 0.22. These estimates reflect prevalences among births without chromosomal anomalies. Relative risks of anophthalmia were modestly higher among women aged 40 or more (relative risk = 2.0, 95% confidence interval 0.5-8.6). Risks were substantially lower for those mothers with >12 years of education, even after adjusting for other study factors, relative risk = 0.6 (0.2-1.7). The risk of anophthalmia was approximately twofold among multiple births compared to singletons. Similar to results for anophthalmia, decreased risks for bilateral microphthalmia were observed for maternal education of 12 years or more and increased risks observed for multiple births. These data show descriptive epidemiologic features of anophthalmia and bilateral microphthalmia.

Adult↗
PubMed1985

Survival of infants with spina bifida--Atlanta, 1972-1979.

We studied the survival of a population-based cohort of 154 infants with spina bifida who were born during the eight-year period from 1972 through 1979 to residents of Atlanta. Our objectives were to describe the cohort's survival experience and to explore relationships between clinical characteristics and survival. Overall, 57% of the cohort survived one year or more. This figure is misleading, however, because it conceals important differences in survival among subgroups of affected infants. From univariate analyses, we observed significant differences in survival among infants categorized by year of birth, birth weight, the open-closed status of the defect, the highest level of the defect on the spine, the presence of multiple major birth defects, and the presence of hydrocephalus at birth. More infants born in the late 1970s survived their first year of life than infants born in the early 1970s; infants with open defects had lower survival than those with closed defects; and infants whose defects were low on the spine had better survival than those whose defects were higher. When comparing the survival experience of this cohort with that of other groups from other areas or from more recent years, health workers must consider referral biases and differences in the distribution of clinical characteristics.

Abnormalities, Multiple↗
PubMed2007

Successful pregnancy rates achieved with day 4 embryo transfers.

OBJECTIVE: To assess the success of day 4 embryo transfers (ETs) following IVF at one institution. DESIGN: Retrospective analysis. SETTING: A university hospital IVF program. PATIENT(S): Two hundred nondonor, fresh IVF cycles. INTERVENTION(S): None. MAIN OUTCOME MEASURE: Outcomes of IVF. Outcome assessments after day 4 ETs included rates of implantation, clinical pregnancy, and singleton and multiple live births. RESULT(S): The overall live-birth rate was 54.4%. Implantation rates were highest in younger age groups, and similar in patients 35-40 years of age. Pregnancy and live-birth rates were similar across all age groups up to age 40 years. Multiple gestations were highest in women < or =40 years of age. CONCLUSION: Acceptable pregnancy rates can be achieved with day 4 ETs.

Adult↗