Trends in the prevalence, risk and pregnancy outcome of multiple births with congenital anomaly: a registry-based study in 14 European countries 1984–2007
Article first published online: 6 FEB 2013
© 2013 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2013 RCOG
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 120, Issue 6, pages 707–716, May 2013
How to Cite
Trends in the prevalence, risk and pregnancy outcome of multiple births with congenital anomaly: a registry-based study in 14 European countries 1984–2007. BJOG 2013;120:707–716., , , , , , , , , , , , , , , , , , , , , , , .
- Issue published online: 9 APR 2013
- Article first published online: 6 FEB 2013
- Manuscript Accepted: 10 DEC 2012
- Northern Ireland Research and Development studentship
- Northern Ireland Public Health Agency. Grant Number: 2010 22 04
- Executive Agency for Health & Consumers
- congenital anomalies;
- multiple births;
- pregnancy outcomes;
To assess the public health consequences of the rise in multiple births with respect to congenital anomalies.
Descriptive epidemiological analysis of data from population-based congenital anomaly registries.
Fourteen European countries.
A total of 5.4 million births 1984–2007, of which 3% were multiple births.
Cases of congenital anomaly included live births, fetal deaths from 20 weeks of gestation and terminations of pregnancy for fetal anomaly.
Main outcome measures
Prevalence rates per 10 000 births and relative risk of congenital anomaly in multiple versus singleton births (1984–2007); proportion prenatally diagnosed, proportion by pregnancy outcome (2000–07). Proportion of pairs where both co-twins were cases.
Prevalence of congenital anomalies from multiple births increased from 5.9 (1984–87) to 10.7 per 10 000 births (2004–07). Relative risk of nonchromosomal anomaly in multiple births was 1.35 (95% CI 1.31–1.39), increasing over time, and of chromosomal anomalies was 0.72 (95% CI 0.65–0.80), decreasing over time. In 11.4% of affected twin pairs both babies had congenital anomalies (2000–07). The prenatal diagnosis rate was similar for multiple and singleton pregnancies. Cases from multiple pregnancies were less likely to be terminations of pregnancy for fetal anomaly, odds ratio 0.41 (95% CI 0.35–0.48) and more likely to be stillbirths and neonatal deaths.
The increase in babies who are both from a multiple pregnancy and affected by a congenital anomaly has implications for prenatal and postnatal service provision. The contribution of assisted reproductive technologies to the increase in risk needs further research. The deficit of chromosomal anomalies among multiple births has relevance for prenatal risk counselling.