Multiple birth rates of Korea and fetal/neonatal/infant mortality in multiple gestation

Abstract

ObjectiveThis study was conducted to analyze recent trends of multiple birth rates (MBR) and fetal/neonatal/infant mortalities according to the number of gestations in Korea.MethodsData from 2009 to 2015 of live births, infant deaths and stillbirths were obtained from the Korean Vital Statistics. Neonatal mortality rate (NMR), infant mortality rate (IMR), and fetal mortality rate (FMR) in singleton, twin and triplet pregnancies were analyzed according to gestational period (GP; ≤ 23, 24–27, 28–31, and 32–36 weeks).ResultsFrom 2009 to 2015, twin and triplet birth rates increased 34.5% and 154.3%, respectively. In twin births, NMR and FMR have been decreased significantly (from 10.92 to 8.62, p = 0.034 and from 41.00 to 30.55, p< 0.001, respectively), but IMR did not show significant decrease. There was no significant change of NMR, IMR, and FMR, in triplet births. Overall, in singleton, twin, and triplet births, NMR was 1.26 ± 0.09, 10.6 ± 1.12, and 34.32 ± 11.72, respectively, and IMR was 2.38 ± 0.26, 14.52 ± 1.38, and 41.13 ± 12.2, respectively. FMRs were 12 ± 1.73, 35.99 ± 3.55, and 88.85 ± 16.55, respectively, in singleton, twin, and triplet pregnancies. In spite of decreasing trends in overall mortalities, the odds ratios of NMRs and IMRs in 2015 were approximately 9-fold and 6-fold higher, respectively, in twin births, and approximately 37-fold and 20-fold higher, respectively, in triplet births, than those in singleton births. There were no significant differences in odds ratios of NMRs and IMRs at GP 32–36 among single, twin, and triplet births, although the odds ratios of FMR at GP 32–36 in triplet gestation was significantly higher than those in singleton and twin gestation.ConclusionNeonatal/infant mortality in multiple births is still significantly high, which is mainly related with preterm birth. Close fetal monitoring is needed to prevent fetal death in triplet pregnancies, after 32 gestational weeks.

Factors affecting neonatal mortality in the general population: evidence from the 2016 Ethiopian Demographic and Health Survey (EDHS)—multilevel analysis

“…The odds of neonatal death was higher among twin births compared with singleton births. This study was supported by a study conducted in Korea [30]. The possible explanation could be twin pregnancy is usually associated with prematurity, which is the most common cause of neonatal death and twin-to-twin transfusion syndrome which further leads to death [31].…”

Incidence Density Rate of Neonatal Mortality and Predictors in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

“…Similarly, the hazard of death among neonates born from multiple pregnancies is considerably higher than single pregnancies. The possible elucidation for this is that multiple births are usually associated with preterm births that can amplify the risk of NM [ 42 , 43 ]. Rural residence is also an independent predictor of NM and the possible rational might be lack of access to health care services during antenatal and postnatal periods which could increase NM.…”

How much have the perinatal outcomes of triplet pregnancies improved over the last two decades?

“…Although the neonatal outcome and prognosis of a triplet pregnancy are poorer than those of singleton and twin pregnancies, advances in perinatal and neonatal care have changed the outcomes of triplet pregnancies over the last few decades [14]. However, a recent study reported that neonatal and infant mortality of triplets have not changed in Korea between 2009 and 2015 [36]. Further research regarding improvements in triplet pregnancy outcomes would be useful for providing counseling regarding SFR to women with triplet pregnancies and a history of infertility.…”