incidence of multiple births has risen in the last 30 years
in 2009, 16 women per 1000 giving birth in England and Wales had multiple births compared with 10 per 1000 in 1980
rising multiple birth rate is due mainly to increasing use of assisted reproduction techniques, including in vitro fertilisation (IVF)
up to 24% of successful IVF procedures result in multiple pregnancies
multiple births currently account for 3% of live births
multiple pregnancy is associated with higher risks for the mother and babies
women with multiple pregnancies have an increased risk of miscarriage, anaemia, hypertensive disorders, haemorrhage, operative delivery and postnatal illness
maternal mortality associated with multiple births is 2.5 times that for singleton births
overall stillbirth rate in multiple pregnancies is higher than in singleton pregnancies: in 2009 the stillbirth rate was 12.3 per 1,000 twin births and 31.1 per 1,000 triplet and higher-order multiple births, compared with 5 per 1,000 singleton births
risk of preterm birth is also considerably higher in multiple pregnancies than in singleton pregnancies, occurring in 50% of twin pregnancies (10% of twin births take place before 32 weeks of gestation)
feto-fetal transfusion syndrome, most commonly occurring in twin pregnancies (where it is termed twin-to-twin transfusion syndrome), is a condition associated with a shared placenta and accounts for about 20% of stillbirths in multiple pregnancies
additional risks to the babies include intrauterine growth restriction and congenital abnormalities
in multiple pregnancies, 66% of unexplained stillbirths are associated with a birthweight of less than the tenth centile, compared with 39% for singleton births
major congenital abnormalities are 4.9% more common in multiple pregnancies than in singleton pregnancies
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