+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Trends in the incidence and mortality of multiple births by socioeconomic deprivation and maternal age in England: population-based cohort study



Trends in the incidence and mortality of multiple births by socioeconomic deprivation and maternal age in England: population-based cohort study



Bmj Open 4(4): E004514



To investigate temporal trends in multiple birth rates and associated stillbirth and neonatal mortality by socioeconomic deprivation and maternal age in England. Population cohort study. England. All live births and stillbirths (1 January 1997 to 31 December 2008). Multiple maternity rate, stillbirth and neonatal death rate by year of birth, decile of socioeconomic deprivation and maternal age. The overall rate of multiple maternities increased over time (+0.64% per annum 95% CI (0.47% to 0.81%)) with an increase in twin maternities (+0.85% per annum 95% CI (0.67% to 1.0%)) but a large decrease in triplet and higher order maternities (-8.32% per annum 95% CI (-9.39% to -7.25%)). Multiple maternities were significantly lower in the most deprived areas, and this was most evident in the older age groups. Women over 40 years of age from the most deprived areas had a 34% lower rate of multiple births compared with similar aged women from the most deprived areas (rate ratio (RR) 0.66 95% CI (0.61 to 0.73)). Multiple births remain at substantially higher risk of neonatal mortality (RR 6.30 95% CI (6.07 to 6.53)). However, for stillbirths, while twins remain at higher risk, this has decreased over time (1997-2000: RR 2.89 (2.69 to 3.10); 2005-2008: RR 2.22 95% CI (2.06 to 2.40)). Socioeconomic inequalities existed in mortality for singletons and multiple births. This period has seen increasing rates of twin pregnancies and decreasing rates of higher order births which have coincided with changes in recommendations regarding assisted reproductive techniques. Socioeconomic differences in multiple births may reflect differential access to these treatments. Improved monitoring of multiple pregnancies is likely to have led to the reductions in stillbirths over this time.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 056687740

Download citation: RISBibTeXText

PMID: 24699461

DOI: 10.1136/bmjopen-2013-004514


Related references

Recent trends in the incidence of multiple births and associated mortality in England and Wales. Archives of Disease in Childhood. Fetal and Neonatal Edition 75(1): F10-F19, 1996

Secular trends in stillbirth by maternal socioeconomic status in Spain 2007-15: a population-based study of 4 million births. European Journal of Public Health 29(6): 1043-1048, 2019

Impact of socioeconomic deprivation on mortality in people with haemorrhagic stroke: a population-based cohort study. Postgraduate Medical Journal 92(1091): 501-505, 2016

Neighborhood deprivation and risk of cancer incidence, mortality and survival: results from a population-based cohort study in Japan. Plos one 9(9): E106729, 2014

Recent trends in the incidence of multiple births and associated mortality. Archives of Disease in Childhood 62(9): 941-950, 1987

A nationally representative study of maternal obesity in England, UK: trends in incidence and demographic inequalities in 619323 births, 19892007. Yearbook of Obstetrics Gynecology and Women's Health 2010: 97-98, 2010

Incidence Trends and Mortality from Childhood Venous Thromboembolism: A Population-Based Cohort Study. Journal of Pediatrics 172: 175-180.E1, 2016

Socioeconomic deprivation, mortality and health of within-city migrants: a population cohort study. Journal of Epidemiology and Community Health 72(6): 519-525, 2018

Socioeconomic deprivation and the burden of head and neck cancer-Regional variations of incidence and mortality in Merseyside and Cheshire, North West, England. Clinical Otolaryngology 43(3): 846-853, 2018

Oral cancer in the North-East of England: Incidence, mortality trends and the link with material deprivation. Community Dentistry and Oral Epidemiology 25(5): 371-376, 1997

Incidence and Mortality of Physician-Diagnosed Primary Sjögren Syndrome: Time Trends Over a 40-Year Period in a Population-Based US Cohort. Mayo Clinic Proceedings 92(5): 734-743, 2017

Trends in the incidence of births and multiple births and the factors that determine the probability of multiple birth after IVF treatment. Human Reproduction 16(12): 2598-2605, 2001

Trends in incidence, prevalence, and mortality of neuromuscular disease in Ontario, Canada: A population-based retrospective cohort study (2003-2014). Plos One 14(3): E0210574, 2019

Secular trends of multiple births with congenital anomalies, by maternal age, in a large California population, 1983-1993. Teratology 55(1): 48, 1997

Longitudinal trends in prostate cancer incidence, mortality, and survival of patients from two Shanghai city districts: a retrospective population-based cohort study, 2000-2009. Bmc Public Health 14: 356, 2015