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Time Trends in Neonatal Mortality Among Twins and Singletons in New York City, 1968–1986

Published online by Cambridge University Press:  01 August 2014

J.L. Kiely*
Affiliation:
Gertrude H. Sergievsky Center, Faculty of Medicine, Columbia University, New York, and National Center for Health Statistics, Hyattsville, Maryland, USA
*
Office of Analysis and Epidemiology, National Center for Health Statistics, Room 1080, 6525 Belcrest Road, Hyattsville, MD 20782, USA.

Abstract

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The objective of this study was to compute yearly neonatal mortality rates (NMRs) in twins and compare these to rates in singletons during the same time period. The focus was on time trends in birthweight-specific twin mortality in the birth population of New York City during the years 1968 to 1986. The study population was all twin livebirths ≥ 500 g birthweight (N = 45,605), with a comparison group of all singleton livebirths in the same birthweight range (N = 2,191,144). Data came from the New York City Department of Health's computerized vital records on livebirths and infant deaths. Between 1968 and 1986 the crude NMR declined 39% in twins and 47% in singletons. In twins there were birthweight-specific declines of 69% to 84% between 1000 g and 2499 g. However, there was only a 19% decline in the twin NMR over 2499 g. This contrasts with a 50% decline in the singleton NMR over 2499 g. In New York City, modern medical care has been remarkably successful in lowering the NMR in low birthweight twins. However, more effort must be made to understand the etiology of perinatal problems in twins with birth weights greater than 2500 g.

Type
Research Article
Copyright
Copyright © The International Society for Twin Studies 1991

References

REFERENCES

1. Alberman, E (1985): Why are stillbirth and neonatal mortality rates continuing to fall? Br J Obstet Gynaecol 92:559564.Google Scholar
2. Botting, BJ, MacDonald Davies, I, Macfarlane, AJ (1987): Recent trends in the incidence of multiple births and associated mortality. Arch Dis Childh 62:941–150.CrossRefGoogle ScholarPubMed
3. Buehler, JW, Kleinman, JC, Hogue, CJ, Strauss, LT, Smith, JC (1987): Birth weight-specific mortality, United States, 1960 and 1980. Pub Health Rep 102:151161.Google Scholar
4. Forbes, JF, Boddy, FA, Pickering, R, Wyllie, MM (1982): Perinatal mortality in Scotland: 1970-9. J Epidemiol Community Health 36:282288.Google Scholar
5. Fowler, MG, Kleinman, JC, Kiely, JL, Kessel, SS (1991): Double jeopardy: U.S. twin infant infant mortality 1983-84. Am J Obstet Gynecol 165:1522.Google Scholar
6. Ghai, V, Vidyasagar, D (1988): Morbidity and mortality factors in twins: An epidemiologic approach. Clin Perinatol 15:123140.Google Scholar
7. Grothe, W, Ruttgers, H (1985): Twin pregnancies: An 11-years review. Acta Genet Med Gemellol 34:193199.Google Scholar
8. Katz, D, Baptista, J, Azen, SP. Pike, MC (1978): Obtaining confidence intervals for the risk ratio in cohort studies. Biometrics 34:469474.Google Scholar
9. Keith, L, Ellis, R, Berger, GS, Depp, R (1980): The Northwestern University multi-hospital twin study. I. A description of 588 twin pregnancies and associated pregnancy loss. Am J Obstet Gynecol 138:781789.Google Scholar
10. Kiely, JL (1990): The epidemiology of perinatal mortality in multiple births. Bull NY Acad Med 66:618637.Google ScholarPubMed
11. Kleinman, JC, Fowler, MG, Kessel, SS (1991): Comparison of infant mortality among twins and singletons: United States 1960 and 1983. Am J Epidemiol 133:133143.Google Scholar
12. Kleinman, JC, Kovar, MG, Feldman, JJ, Young, CA (1978): A comparison of 1960 and 1973-74 early neonatal mortality in selected states. Am J Epidemiol 108:454469.Google Scholar
13. McCarthy, BJ, Sachs, BP, Layde, PM, Burton, A, Terry, JS, Rochat, R (1981): The epidemiology of neonatal death in twins. Am J Obstet Gynecol 141:252256.Google Scholar
14. Osborne, GK, Patel, NB (1985): An assessment of perinatal mortality in twin pregnancies in Dundee. Acta Genet Med Gemellol 34:193199.Google Scholar
15. Pharoah, POD, Alberman, ED (1990) Annual statistical review. Arch Dis Childh 65:147151.Google Scholar