Perinatal Indicator: Multiple Births

Definition

The birth of more than one baby from a single pregnancy; for example, twins or triplets. The birth of three or more babies from a single pregnancy is called a higher order multiple birth.

Why Does This Matter?

Before the advent of assisted reproductive technology (ART), including fertility treatments and in vitro fertilization, multiple births were uncommon. Twins occur spontaneously in 1.6% of live births, and triplets and higher-order multiples even more rarely. Currently, multiples account for 2.9% of live births in LA County—95% are twins and the remainder higher order multiple births. Such multifetal pregnancies can put both mother and infants at risk.

Mothers carrying multiple fetuses are 3 to 7 times more likely to experience complications during pregnancy, birth, or the period immediately following birth. Risks include preeclampsia, iron-deficiency anemia, uterine rupture, premature rupture of membranes, preterm birth, need for operative delivery, postpartum hemorrhage, and postpartum depression. Infants born of multifetal pregnancies are 4 to 10 times more likely to experience complications, including intrauterine growth restriction, preterm birth, low birthweight, and cerebral palsy. Infant twins are 4.5 times more likely to die—and triplets 9 times more likely—most often due to complications of preterm birth. Risk of infant death increases with the number of fetuses in the pregnancy.

The rates per 1000 live births are:

  • Singleton
  • Twins 
  • Triplets         
  • Quadruplets  
6.0
29.84
59.60
105.26

Even those infants born healthy will often experience delays in language and reading, as well as behavioral problems. This is most likely due to limited individual attention from parents and the phenomenon of “twin language.”

For further information, please read the LA Best Babies Network Perinatal Scorecard

Multiple Deliveries by Race/Ethnicity  in Los Angles County and California (2000-2006)
Downland PDF Fact Sheet 1

  • In general, from 2000 through 2006, the average rates of multiple births steadily increased across all ethnic groups in L.A. County and California.
  • From 2000 to 2006, Hispanic  women in L.A. County had the largest increase (14.8%) of deliveries of multiples as compared to white, Asian, and black women in the same area.
  • From 2000 to 2006, African American women in L.A. County had the smallest increase (1.05%) of deliveries of multiples as compared to white, Asian, and Hispanic women in the same area.
  • From 2000 to 2006, white women in L.A. County experienced a 10.8% increase in deliveries of multiples, while white women in California experienced a 9.2% increase in births of multiples.

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Time period
Ratio per 1000 live births
 
California
Hispanic
White
Black
American Indian
Asian
Total
 
Hispanic
White
Black
American Indian
Asian
Total
2000-2002
19.6
47.4
38
28.9
26.1
27.1
 
20.4
40.3
38
28.1
24.6
28.5
2002-2004
20.9
49
37.1
44
28.5
28.4
 
21.1
42
39
32
27.7
29.7
2004-2006
22.5
52.5
38.4
38.7
29.4
30
 
22.2
44
40
26.3
29.4
31

Sources:  National Center for Health Statistics, final natality data. Retrieved 12/14/09 from www.Marchofdimes.com/peristats.

 

2005 Los Angeles Live Birth Multiples Sets by Mother's Race/Ethnicity
White
Black
American Indian
Asian
Pacific Islander
Latino
Unknown/Other
LA County
Singleton
97.23%
97.94%
98.25%
98.48%
98.31%
98.82%
96.96%
98.43%
Twin sets
2.64%
2.00%
1.75%
1.50%
1.52%
1.15%
2.92%
1.52%
Triplet sets
0.13%
0.06%
0.00%
0.03%
0.17%
0.02%
0.12%
0.05%
  • In 2005, 1.57% of all live births in Los Angeles County were multiple deliveries.
  • In 2005, white women in Los Angeles County had  the highest percent (2.7%) of multiple deliveries as compared to black, American Indian, Asian, Pacific Islander, and Latino women.  However, Pacific Islander women had the highest rate of delivering triplets (0.17% compared to 0.13% for White women).
  • In 2005, only 1.18% of Latino women had multiple deliveries.
  • From 2004 through 2006, on average, there were 970 singleton deliveries, and 30 multiple deliveries per every 1,000 live births in Los Angeles County.
  • From 2004 through 2006, women 40 years and older in Los Angeles County had the highest ratio of multiple deliveries (72.9 per 1,000 live births)

Download PDF fact sheet 2

multiple births2mb mat   age

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Sources: National Center for Health Statistics, final natality. Retrieved 12/14/09 from www.Marchofdimes.com/peristats