Breaking News
May 3, 2019 - Vaping and Smoking May Signal Greater Motivation to Quit
May 3, 2019 - Dementia looks different in brains of Hispanics
May 3, 2019 - Short-Staffed Nursing Homes See Drop In Medicare Ratings
May 3, 2019 - Study of teens with eating disorders explores how substance users differ from non-substance users
May 3, 2019 - Scientists develop new video game that may help in the study of Alzheimer’s
May 3, 2019 - Arc Bio introduces Galileo Pathogen Solution product line at ASM Clinical Virology Symposium
May 3, 2019 - Cornell University study uncovers relationship between starch digestion gene and gut bacteria
May 3, 2019 - How to Safely Use Glucose Meters and Test Strips for Diabetes
May 3, 2019 - Anti-inflammatory drugs ineffective for prevention of Alzheimer’s disease
May 3, 2019 - Study tracks Pennsylvania’s oil and gas waste-disposal practices
May 3, 2019 - Creating a better radiation diagnostic test for astronauts
May 3, 2019 - Vegans are often deficient in these four nutrients
May 3, 2019 - PPDC announces seed grants to develop medical devices for children
May 3, 2019 - Study maps out the frequency and impact of water polo head injuries
May 3, 2019 - Research on Reddit identifies risks associated with unproven treatments for opioid addiction
May 3, 2019 - Good smells may help ease tobacco cravings
May 3, 2019 - Medical financial hardship found to be very common among people in the United States
May 3, 2019 - Researchers develop multimodal system for personalized post-stroke rehabilitation
May 3, 2019 - Study shows significant mortality benefit with CABG over percutaneous coronary intervention
May 3, 2019 - Will gene-editing of human embryos ever be justifiable?
May 3, 2019 - FDA Approves Dengvaxia (dengue vaccine) for the Prevention of Dengue Disease in Endemic Regions
May 3, 2019 - Why Tonsillitis Keeps Coming Back
May 3, 2019 - Fighting the opioid epidemic with data
May 3, 2019 - Maggot sausages may soon be a reality
May 3, 2019 - Deletion of ATDC gene prevents development of pancreatic cancer in mice
May 2, 2019 - Targeted Therapy Promising for Rare Hematologic Cancer
May 2, 2019 - Alzheimer’s disease is a ‘double-prion disorder,’ study shows
May 2, 2019 - Reservoir bugs: How one bacterial menace makes its home in the human stomach
May 2, 2019 - Clinical, Admin Staff From Cardiology Get Sneak Peek at Epic
May 2, 2019 - Depression increases hospital use and mortality in children
May 2, 2019 - Vicon and NOC support CURE International to create first gait lab in Ethiopia
May 2, 2019 - Researchers use 3D printer to make paper organs
May 2, 2019 - Viral infection in utero associated with behavioral abnormalities in offspring
May 2, 2019 - U.S. Teen Opioid Deaths Soaring
May 2, 2019 - Opioid distribution data should be public
May 2, 2019 - In the Spotlight: “I’m learning every single day”
May 2, 2019 - 2019 Schaefer Scholars Announced
May 2, 2019 - Podcast: KHN’s ‘What The Health?’ Bye-Bye, ACA, And Hello ‘Medicare-For-All’?
May 2, 2019 - Study describes new viral molecular evasion mechanism used by cytomegalovirus
May 2, 2019 - SLU study suggests a more equitable way for Medicare reimbursement
May 2, 2019 - Scientists discover first gene involved in lower urinary tract obstruction
May 2, 2019 - Researchers identify 34 genes associated with increased risk of ovarian cancer
May 2, 2019 - Many low-income infants receive formula in the first few days of life, finds study
May 2, 2019 - Global study finds high success rate for hip and knee replacements
May 2, 2019 - Taking depression seriously: What is it?
May 2, 2019 - With Head Injuries Mounting, Will Cities Put Their Feet Down On E-Scooters?
May 2, 2019 - Scientists develop small fluorophores for tracking metabolites in living cells
May 2, 2019 - Study casts new light into how mothers’ and babies’ genes influence birth weight
May 2, 2019 - Researchers uncover new brain mechanisms regulating body weight
May 2, 2019 - Organ-on-chip systems offered to Asia-Pacific regions by Sydney’s AXT
May 2, 2019 - Adoption of new rules drops readmission penalties against safety net hospitals
May 2, 2019 - Kids and teens who consume zero-calorie sweetened beverages do not save calories
May 2, 2019 - Improved procedure for cancer-related erectile dysfunction
May 2, 2019 - Hormone may improve social behavior in autism
May 2, 2019 - Alzheimer’s disease may be caused by infectious proteins called prions
May 2, 2019 - Even Doctors Can’t Navigate Our ‘Broken Health Care System’
May 2, 2019 - Study looks at the impact on criminal persistence of head injuries
May 2, 2019 - Honey ‘as high in sugars as table sugar’
May 2, 2019 - Innovations to U.S. food system could help consumers in choosing healthy foods
May 2, 2019 - FDA Approves Mavyret (glecaprevir and pibrentasvir) as First Treatment for All Genotypes of Hepatitis C in Pediatric Patients
May 2, 2019 - Women underreport prevalence and intensity of their own snoring
May 2, 2019 - Concussion summit focuses on science behind brain injury
May 2, 2019 - Booker’s Argument For Environmental Justice Stays Within The Lines
May 2, 2019 - Cornell research explains increased metastatic cancer risk in diabetics
May 2, 2019 - Mount Sinai study provides fresh insights into cellular pathways that cause cancer
May 2, 2019 - Researchers to study link between prenatal pesticide exposures and childhood ADHD
May 2, 2019 - CoGEN Congress 2019: Speakers’ overviews
May 2, 2019 - A new strategy for managing diabetic macular edema in people with good vision
May 2, 2019 - Sagent Pharmaceuticals Issues Voluntary Nationwide Recall of Ketorolac Tromethamine Injection, USP, 60mg/2mL (30mg per mL) Due to Lack of Sterility Assurance
May 2, 2019 - Screen time associated with behavioral problems in preschoolers
May 2, 2019 - Hormone reduces social impairment in kids with autism | News Center
May 2, 2019 - Researchers synthesize peroxidase-mimicking nanozyme with low cost and superior catalytic activity
May 2, 2019 - Study results of a potential drug to treat Type 2 diabetes in children announced
May 2, 2019 - Multigene test helps doctors to make effective treatment decisions for breast cancer patients
May 2, 2019 - UNC School of Medicine initiative providing unique care to dementia patients
May 2, 2019 - Nestlé Health Science and VHP join forces to launch innovative COPES program for cancer patients
May 2, 2019 - Study examines how our brain generates consciousness and loses it during anesthesia
May 2, 2019 - Transition Support Program May Aid Young Adults With Type 1 Diabetes
May 2, 2019 - Study shows how neutrophils exacerbate atherosclerosis by inducing smooth muscle-cell death
May 2, 2019 - Research reveals complexity of how we make decisions
Delayed childbearing is a growing source of multiple births, study shows

Delayed childbearing is a growing source of multiple births, study shows

The observed rate of multiple births per 1,000 live births from 1971 to 2016 and the fractions that can be attributed to delayed childbearing and assisted reproductive technologies, projected out to 2025. Credit: Brown University

Starting in the 1980s, the number of multiple births—twins, triplets, quadruplets and quintuplets—steadily increased from about 20 sets per 1,000 live births to almost 35 sets per 1,000 live births in the 2010s.

That trend presents some concerns, says Dr. Eli Adashi, professor of obstetrics and gynecology at Brown University’s Warren Alpert Medical School—multiple births come with various medical risks to both mother and babies, chief among them the risk of premature birth.

Adashi and colleague Roee Gutman, an assistant professor of biostatistics at Brown’s School of Public Health, analyzed Centers for Disease Control and Prevention (CDC) birth data to determine how much of this surge in multiple births is the natural result of women choosing to have children later in life—as compared to assisted reproductive technologies, to which the phenomenon is most commonly attributed.

Their results were published on Tuesday, Sept. 11, in the October issue of the journal Obstetrics & Gynecology.

Adashi has a long history of analyzing the sources of multiple births. Until he met a colleague’s natural quadruplets, however, Adashi controlled for maternal age in his analyses but didn’t focus on the role that delayed childbearing may have on the boom of twin, triplet and quadruplet births.

“Our question was: Does this social phenomenon of delayed childbearing have an impact on the incidence of multiple births in the United States?” Adashi said. “In the paper, we showed that yes, indeed, not all the multiple births out there have to do with fertility drugs or in-vitro fertilization (IVF). There’s a sizable proportion of multiple births that are attributable simply to delaying childbearing. And the percentage of these spontaneous multiples seems to be growing.”

The fact that older women are more likely to have twins, triplets and quadruplets has been known for quite some time, Adashi said. In fact, he found a 150-year-old medical paper on the topic. But while the role that delayed childbearing plays in the increase in multiple births from the 1980s onward has been observed, it hadn’t been analyzed with reference data allowing statistical projections until now, he said.

Using CDC data from 1949 to 1966, before assisted reproductive technologies were available, the researchers found that by the time white women reach age 35, they are about three times more likely to have fraternal, non-identical twins. African American women are four times more likely to have twins at age 35. The risk for triplets and quadruplets goes up four and a half times and six and half times, respectively.

In addition to the advent of assisted reproductive technologies, the study noted that the period of 1971 to 2016 also brought pronounced social changes and more choices by families to delay childbearing. The study found that the fraction of white mothers who were between 30 and 40 years old increased from 16 percent in 1971 to 42 percent in 2015. Black mothers of this age increased from 14 percent to 31 percent over the same time period. The researchers found that this increase in the number of older women having children without assisted reproductive technologies played a definite role in the number of multiple births that exceeded the expected rate of about 20 multiples per 1,000 live births.

In 2016, delayed childbearing was solely responsible for 24 percent of the multiple births for white women beyond expected rates and 38 percent for black women. Furthermore, by extrapolating delayed childbearing rates, the researchers projected that by 2025, women having children later without using assisted reproductive technologies could account for 46 percent of the excess multiple births for white women and 40 percent for black women.

Adashi said the goal of the research is not to intrude upon personal choices about how and when to have families, but to understand the factors that have contributed to the surge in multiples and raise awareness of the risks of delayed childbearing.

“People need to be aware of the increased risk of multiple births among the other more established concerns for advanced maternal age, such as Down syndrome, preterm birth and pre-eclampsia,” he said.


Explore further:
IVF improving but fertility treatments keep multiple births high

More information:
Delayed Childbearing as a Growing, Previously Unrecognized Contributor to the National Plural Birth Excess, Obstetrics & Gynecology (2018). DOI: 10.1097/AOG.0000000000002853 , https://journals.lww.com/greenjournal/Abstract/publishahead/Delayed_Childbearing_as_a_Growing,_Previously.97945.aspx

Journal reference:
Obstetrics & Gynecology

Provided by:
Brown University

Tagged with:

About author

Related Articles