Incidence of Handicaps in Multiple Births and Associated Factors

Abstract

This study investigated the degree of risk of handicap in twins, triplets, quadruplets and quintuplets and associated factors, and examined the clustering tendency of handicaps. The sample was recruited from the Kinki University Twin and Higher Order Multiple Birth Registry. This panel consisted of 705 pairs of twins (1410 twins), 96 sets of triplets (287 triplets excluding 1 infant death), 7 sets of quadruplets (27 quadruplets excluding 1 infant death), and 2 sets of quintuplets (10 quintuplets), all of whom were born after 1977. The incidence of handicap was 3.7% in twins, 8.7% in triplets, 11.1% in quadruplets, and 10.0% in quintuplets. The risk of prodicing at least 1 handicapped child was approximately 1 in 13 pairs of twins (7.4%), 1 in 4 or 5 sets of triplets (21.6%), and 1 in 2 sets of quadruplet and quintuplets (50%). There was a significantly higher clustering tendency of handicaps in twins and triplets compared with the expected frequency calculated from the incidence rate of handicap. Four significant risk factors for subsequent handicap were found by logistic regression: gestation number, shortening of gestational age, premature rupture of the membrane, and toxemia during pregnancy.

Clinical outcomes of elective single morula embryo transfer versus elective single blastocyst embryo transfer in IVF-ET

“…However, if two or more embryos are transferred to maintain an acceptable pregnancy rate, it will increase the risk of multiple pregnancies. It has been reported that multiple pregnancies result in adverse outcomes such as higher risks of prematurity, low or very low birth weight, intrauterine growth retardation, pregnancy-induced hypertension, and caesarean section [1][2][3]. Also, twin pregnancies have a six-fold increased risk of perinatal mortality and morbidity [4] and a fourfold increased risk of cerebral palsy compared to singleton pregnancies [5].…”

Contemporary risks of maternal morbidity and adverse outcomes with increasing maternal age and plurality

“…Factors for this rapid rise include the widespread use and availability of infertility treatments, in combination with the trend of childbearing at older ages. Compared to singletons, infants of multiple pregnancies are much more likely to be born early preterm and very low birthweight, important well-documented factors that contribute to their excess morbidity and mortality (2)(3)(4). In contrast, far less is known about how multiple pregnancy affects the health of the mother.…”

Embarazo Triple: Complicaciones Maternas Y Perinatales

“…La preeclampsia, la rotura prematura de membranas y el nacimiento antes de las 32 semanas, son las complicaciones maternas que más se asocian a estas gestaciones (13).…”