Less is more: the risks of multiple births
- 31 October 2000
- journal article
- review article
- Published by Elsevier BV in Fertility and Sterility
- Vol. 74 (4), 617-623
- https://doi.org/10.1016/s0015-0282(00)00713-5
Abstract
Objective: To review the medical, social, and financial risks caused by the birth of multiples that need to be addressed in policy and practice. Result(s): Many risks of multiple births are described in the literature. The medical risks to the offspring include death, low birth weight, deformational plagiocephaly, and other physical and mental disabilities. Risks to the women include premature labor, premature delivery, pregnancy-induced hypertension, toxemia, gestational diabetes, and vaginal-uterine hemorrhage. Children born in multiples face difficulty socializing, developmental delays, and behavioral problems, whereas their parents risk exhaustion, depression, and anxiety. In addition to personal costs faced by families, society often bears the financial costs of overburdened hospitals, caps on insurance and/or inability of parents to cover expenses. Conclusion(s): Multiple births present potential acute and long-term medical risks to the pregnant woman and her children. However, more long-term follow-up research and more research on outcomes with higher-order multiples are needed. In designing practices and policies to improve the success of IVF while reducing the risk of multiples, it is important to balance the many interests involved. At a minimum, providers and patients need to be educated about the risks of multiple gestation so that steps can be taken to prevent adverse outcomes.Keywords
This publication has 9 references indexed in Scilit:
- Comparison of blastocyst transfer with day 3 embryo transfer in similar patient populationsFertility and Sterility, 2000
- Multiple-birth Infants at Higher Risk for Development of Deformational PlagiocephalyPediatrics, 1999
- Annual Summary of Vital Statistics—1997Published by American Academy of Pediatrics (AAP) ,1998
- Reducing the Risk of Multiple Births by Transfer of Two Embryos after in Vitro FertilizationNew England Journal of Medicine, 1998
- Cognitive, educational, and behavioural outcomes at 7 to 8 years in a national very low birthweight cohortArchives of Disease in Childhood: Fetal & Neonatal, 1998
- Medical Miracle or Medical Mischief? The Saga of the McCaughey SeptupletsThe Hastings Center Report, 1998
- IVF in the US: multiple gestation, economic competition, and the necessity of excess.Human Reproduction, 1997
- New developments in topical estrogen therapyFertility and Sterility, 1997
- The Economic Impact of Multiple-Gestation Pregnancies and the Contribution of Assisted-Reproduction Techniques to Their IncidenceNew England Journal of Medicine, 1994