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Complete Health Indicator Report of Multiple Births

Definition

Plurality is the number of all live births and pregnancy losses (miscarriages, ectopic pregnancies, fetal deaths, selective reductions) in a pregnancy. Multiple births are twins, triplets, quadruplets, and higher order births.

Numerator

Number of live births which were part of a multiple pregnancy (twin, triplet, etc.)

Denominator

Total number of live births

Data Interpretation Issues

Each infant in a multiple birth is counted separately, so, for example, three triplets refers to three live born infants, not three sets of triplets and not necessarily three infants from the same triplet set. If, for example, a mother has a triplet pregnancy and one child is not live born, the two live born infants are each still considered to be one of a set of triplets, not twins.

Why Is This Important?

There is a high risk of adverse outcome for multiple births. The outcomes are addressed in the respective indicator profiles.

How Are We Doing?

There were 38% more multiple births in 2016 than in 1990 and the rate of multiple birth increased 70% in that same time period. Both the number and rate of multiple births generally increased through the 1990s and 2000s before beginning to decline after 2011. The vast majority (97%) of multiple births are twins. The number of triplets peaked in 1998 (at 467) and the proportion of multiples that are triplets is now less than one-third of what it was that year (2.8% and 10.1%, respectively).

How Do We Compare With the U.S.?

The multiple birth rate in New Jersey has been higher than that of the nation as a whole since 1991 and currently is 15% higher. This is thought to be due, in part, to assisted reproductive technology (ART) and the proximity of such services throughout the state, as well as the affluence of some parts of New Jersey compared to other parts of the country. Since 2001, state law has required health insurers to provide coverage for medically necessary expenses incurred in diagnosis and treatment of infertility, including ART.[http://www.njleg.state.nj.us/2000/Bills/PL01/236_.HTM ^1^]

Evidence-based Practices

The American College of Obstetricians and Gynecologists' (ACOG) Committee on Ethics published an Opinion report in 2017 advising obstetrician-gynecologists (Ob/Gyns) to be knowledgeable about the medical risks of multifetal pregnancy, the potential medical benefits of multifetal pregnancy reduction, and the complex ethical issues inherent in decisions regarding multifetal pregnancy reduction. Multifetal pregnancies should be prevented whenever possible. When multifetal pregnancies do occur, incorporating the ethical framework presented in the Committee Opinion will help Ob/Gyns counsel and guide patients as they make decisions regarding continuing or reducing their multifetal pregnancies.[https://www.acog.org/Clinical-Guidance-and-Publications/Committee_Opinions/Committee_on-Ethics/Multifetal-Pregnancy-Reduction ^2^]


Related Indicators

Related Health Status Outcomes Indicators:




Graphical Data Views

Multiple Births by Year, New Jersey and the U.S., 1990-2016

::chart - missing::

US/NJYearPercentage of Live BirthsNumer- ator
Record Count: 70
US19902.3%96,893
US19912.4%98,125
US19922.4%99,255
US19932.5%100,613
US19942.6%101,658
US19952.6%101,709
US19962.7%106,689
US19972.9%110,874
US19983.0%118,295
US19993.1%121,628
US20003.1%126,241
US20013.2%128,717
US20023.3%132,535
US20033.3%136,328
US20043.4%139,494
US20053.4%139,816
US20063.4%143,625
US20073.4%145,388
US20083.4%144,928
US20093.5%143,557
US20103.5%138,065
US20113.5%136,686
US20123.4%135,943
US20133.5%137,024
US20143.5%139,862
US20153.5%137,278
US20163.4%135,726
NJ19902.3%2,890
NJ19912.4%2,959
NJ19922.8%3,358
NJ19932.9%3,422
NJ19943.0%3,543
NJ19953.0%3,467
NJ19963.5%4,037
NJ19973.7%4,246
NJ19984.0%4,610
NJ19994.2%4,734
NJ20003.9%4,542
NJ20014.0%4,659
NJ20024.3%4,952
NJ20034.4%5,140
NJ20044.5%5,201
NJ20054.3%4,902
NJ20064.6%5,248
NJ20074.6%5,326
NJ20084.6%5,125
NJ20094.6%5,034
NJ20104.6%4,856
NJ20114.8%5,031
NJ20124.5%4,656
NJ20134.5%4,626
NJ20144.3%4,449
NJ20154.1%4,169
NJ20163.9%4,001

Data Sources

  • Birth Certificate Database, Office of Vital Statistics and Registry, New Jersey Department of Health
  • National Center for Health Statistics, Centers for Disease Control and Prevention (CDC), [https://www.cdc.gov/nchs/index.htm]


Multiple Births Distribution, New Jersey, 2014-2016

::chart - missing::

The proportion of multiple births that are quadruplets is so small that it is barely visible on the pie graph.
PluralityPercentage of Live Multiple Births
Record Count: 3
Twin97.1%
Triplet2.8%
Quadruplet0.2%

Data Source

Birth Certificate Database, Office of Vital Statistics and Registry, New Jersey Department of Health


Multiple Births by Mother's Age, New Jersey, 2014-2016

::chart - missing::

Older mothers have a higher spontaneous (i.e., without the use of fertility therapies) multiple birth rate. However, older maternal age accounts for only about one-third of the total rise in the multiple birth rate over time.[3]
Age GroupPercentage of Live Births
Record Count: 8
Under 181.0%
18-191.9%
20-242.4%
25-293.3%
30-344.4%
35-395.5%
40-446.7%
45+18.0%

Data Source

Birth Certificate Database, Office of Vital Statistics and Registry, New Jersey Department of Health


Multiple Births by Mother's Race/Ethnicity, New Jersey, 2014-2016

::chart - missing::

Race/EthnicityPercentage of Live Births
Record Count: 6
White4.7%
Black4.7%
Hispanic3.0%
Asian3.5%
New Jersey4.1%
United States3.5%

Data Notes

Data for White, Black, and Asian do not include Hispanics. Hispanic ethnicity includes persons of any race.

Data Source

Birth Certificate Database, Office of Vital Statistics and Registry, New Jersey Department of Health


Multiple Births by County of Residence, New Jersey, 2014-2016

::chart - missing::

CountyPercentage of Live Births
Record Count: 23
Atlantic3.4%
Bergen4.7%
Burlington4.4%
Camden4.2%
Cape May4.4%
Cumberland3.6%
Essex3.9%
Gloucester4.2%
Hudson3.9%
Hunterdon4.4%
Mercer3.9%
Middlesex3.7%
Monmouth4.9%
Morris4.4%
Ocean4.0%
Passaic3.7%
Salem3.6%
Somerset4.6%
Sussex3.8%
Union3.7%
Warren5.4%
New Jersey4.1%
United States3.5%

Data Source

Birth Certificate Database, Office of Vital Statistics and Registry, New Jersey Department of Health

References and Community Resources

1. NJ P.L.2001, c.236: [http://www.njleg.state.nj.us/2000/Bills/PL01/236_.HTM] 2. ACOG Ethics Committee [http://www.acog.org/Resources_And_Publications/Committee_Opinions/Committee_on_Ethics/Multifetal_Pregnancy_Reduction Opinion on Multifetal Pregnancy Reduction] 3. Martin JA, Hamilton BE, Osterman MJK. [https://www.cdc.gov/nchs/data/databriefs/db80.htm Three decades of twin births in the United States, 1980-2009]. NCHS data brief, no 80. Hyattsville, MD: National Center for Health Statistics. 2012. National Center for Health Statistics Multiple Births Fast Stats: [https://www.cdc.gov/nchs/fastats/multiple.htm]

Page Content Updated On 04/27/2018, Published on 04/27/2018
The information provided above is from the Department of Health's NJSHAD web site (https://nj.gov/health/shad). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Thu, 16 August 2018 10:07:17 from Department of Health, New Jersey State Health Assessment Data Web site: https://nj.gov/health/shad ".

Content updated: Wed, 23 May 2018 05:01:08 EDT