No abstract available.
Humans ; Multiple Birth Offspring ; Twins*

No abstract available.
Humans ; Korea* ; Multiple Birth Offspring*

PURPOSE: To figure out the contribution of maternal age distribution to the preterm birth (PTB) rate of multiple births between 1997~98 and 2014~15. METHODS: Multiple birth certificate data of Korea Statistics were used for this analysis. There were 18,557 births in 1997~98 and 30,992 births in 2014~15. Kitagawa's decomposition method was used to examine the contribution of age-specific PTB rate and maternal age distribution of multiple births to overall increment of PTB rate in multiple births between 1997~98 and 2014~15. RESULTS: PTB rate of multiple births increased from 32.40 percent to 58.22 percent (odds ratio: 1.80, 95% confidence interval: 1.76~1.84) during 1997-2015. PTB rate of multiple births greatly increased for women aged 25~29 years (odds ratio: 2.09) during the same period. The rates increased 1.88 times for women aged ≤24 years, followed by women aged 30~34 years (OR: 1.65), women aged 35~39 years (1.54), and women aged ≥ 40 years (1.36). Most (78.7%) of the overall increment in PTB rate of multiple births was attributable to the increase in the dimension of women aged 30~34 years, and 49.9 percent for women aged 35~39 years. CONCLUSION: The total increment in the PTB rate of multiple births was explained by increase the proportion and the PTB rate of women aged 30~39 years. More research is needed to comprehend the contributing age factors to PTB rate of multiple births.
Age Factors ; Female ; Humans ; Incidence* ; Korea ; Maternal Age* ; Methods ; Multiple Birth Offspring* ; Parturition ; Premature Birth*

OBJECTIVE: The purpose of this study was to evaluate the clinical course of discordant fetal growth and perinatal outcome in relation to dichorionic and monochorionic twin for different degrees of birth weight difference. METHODS: Between Jan. 1992 and Dec, 1997, 154 twin pairs were born at Yonsei medical center and there were 36 pairs of twins which had 20% or more birth weight difference. The placental examination were performed routinely on all multiple births and 13 pairs of dichorionic twins and 23 pairs of monochorionic twins were consisted of the study population. These twin pairs were divided into three groups based on birth weight difference: 20-29%(as group A), 30-39%(as group B), and 40% or more(as group C). Gestational age, birth weight, gender and perinatal outcomes were observed for each twin pairs. RESULTS: The perinatal death in the monochorionic twin pairs showed 9(34.6%) as group A, 4(50%) as group B, and 5(41,7%) as group C and in the dichorionic twin paus 1(10.0%) as youp A, 0 as group B and 5(62.5%) as group C. Up to 40% of birth weight difference, dichorionic twin pairs showed good perinatal outcomes compared with monochorionic twin pairs but over 40% or more of birth weight diffaence, however there were no significant difference of perinatal outcomes by chorionicity. In the monochorionic twin pairs, the cause of perinatal death showed 3 cases of prematurity, 2 cases of congenital anomalies and 2 cases of IIOC and 2 cases of cord lesions in group A whenas in the group B and C 3 cases of prematurity and 6 cases of congenital anomalies. In the dichorionic twin pairs, different-sex twin pairs showed no perinatal death in all three groups but in same-sex twin pairs there were 6 perinatal deaths. CONCLUSION: More recent improved fetal ultrasonographic surveillance such as determination of chorionicity, identification of fetal sex and evaluation of fetal anomalies help to make a clinical decision in growth discordant twin up to 40% of weight difference each other.
Birth Weight ; Chorion ; Fetal Development* ; Gestational Age ; Humans ; Multiple Birth Offspring ; Pregnancy, Twin

PURPOSE: To determine the secular trend of the multiple birth rate in Korea from 1981 to 2017. METHODS: This study used birth certificate data covering the years 1981–2017 (20,948,901 births), provided by Statistics Korea. The impact of assisted reproductive technologies (ART) on multiple birth was analyzed by examining data prior to and after the introduction of ART and the national support program for infertile couples in South Korea. The odds ratio (OR) and 95% confidence intervals were calculated to describe the secular trend in the multiple birth rate per 100 births. RESULTS: During this period, the multiple birth rate per 100 births increased by 277 percent from 1.031 to 3.891, the twin birth rate increased from 1.013 to 3.807 (275%), and the triplet birth rate increased from 0.018 to 0.084 (363%). The secular trend of the multiple birth rate remained in the 1.000 level during 1981–1991, but has been rising steadily since 1992. The average increment of the multiple birth rate was 3.9% annually from 1981 through 2017 (peaking at more than 10 percent during 2006–2007). Prior to the introduction of ART in Korea (1981–1984), the multiple birth rate was 1.007, but after its introduction, the multiple birth rate was 1.005 in 1985–1989 (OR, 0.998; 95% confidence interval, 0.982–1.014), 1.084 in 1990–1994 (1.007; 1.060–1.094), 1.891 in 2000–2004 (1.894; 1.866–1.922), 3.127 in 2010–2014 (3.173; 3.129–3.217), and 3.811 in 2015–2017 (3.893; 3.835–3.952). CONCLUSION: Over the past three decades, multiple births have risen dramatically in Korea, primarily due to the increasingly widespread use of fertility therapies, and the delayed age of childbearing. There is a need for more research to understand the factors contributing to multiple births, and the national birth registration systems ought to be reformed to monitor whether multiple births originated spontaneously or from assisted-conception.
Birth Certificates ; Birth Rate ; Family Characteristics ; Fertility ; Humans ; Korea ; Multiple Birth Offspring ; Odds Ratio ; Parturition ; Reproductive Techniques, Assisted ; Triplets ; Twins

The cutis marmorata telangiectatica congenita(CMTC) is characterized by the presence of purplish, reticulated vascular network with a localized or generalized distribution. The condition is present at birth and tends to improve with age, although some patients have lesion that remains relatively fixed throughout life. Multiple birth defects have been found in 50% of patients with CMTC. We experienced a case of CMTC in a 5-days-old infant. The patient had purplish reticulated patches with telangiectasia on the both arms, chest, abdomen, back, and both legs. The area of involved skin showed an atrophic change. There were no other associated anomalies. Also, we reviewed cases previously reported in Korea.
Abdomen ; Arm ; Humans ; Infant ; Korea ; Leg ; Multiple Birth Offspring ; Parturition ; Skin ; Telangiectasis ; Thorax

BACKGROUND: As the aging society progresses, the average age of mothers is also increasing. Advanced maternal age has been known to be associated with perinatal outcomes, as well as birth weight (BW). In this study, we aimed to investigate the perinatal factors associated with low birth weight infants (LBWIs) using birth statistics of the Korean population. METHODS: Birth statistics between 1993 and 2016 from the Korean Statistical Information Service were reviewed. We investigated 12,856,614 data points, which included the number of births, BWs, percentage of preterm births and LBWIs, multiple pregnancies, and maternal age. RESULTS: The proportion of LBWIs delivered by mothers of advanced maternal age has gradually increased since 1993. In addition, the proportion of older mothers (≥ 35 years old) giving birth to LBWIs has increased over the years. Average BW has a negative correlation with the ratio of preterm births, LBW, multiple births, and advanced maternal age. The mean BW also has a negative correlation with maternal age. CONCLUSION: This study shows that the average BW continues to decline, and the incidence of LBWIs is increasing in Korea since 1993. This study also revealed that several perinatal factors, including percentage of preterm births, LBWIs, multiple births, and maternal age influence the mean BW. Although this study did not investigate the effects of decreasing mean BW on perinatal health, future research is worth discussing.
Aging ; Birth Weight* ; Female ; Humans ; Incidence* ; Infant ; Infant, Low Birth Weight* ; Infant, Newborn ; Information Services ; Korea* ; Maternal Age* ; Mothers ; Multiple Birth Offspring ; Parturition* ; Pregnancy ; Pregnancy, Multiple ; Premature Birth

PURPOSE: The objective of the study was to compare contribution of maternal age to preterm birth (PTB) rates between 1997~99 and 2012~14. METHODS: We used 1997~99 (1,872,720 births) and 2012~14 (1,280,348 births) singleton birth certificated data of Korea Statistics excluding multiple birth and extra-marital birth cases. We decomposed the contributions of age-specific PTB rates and maternal age distribution (Kitagawa's decomposition method) to overall PTB rates during the period. Odds ratio (OR) and 95% confidence intervals were calculated from logistic regression to describe the secular trend of PTB rate by birth year and maternal age. RESULTS: The incidence of PTB increased 1.5 times, from 3.0 percent to 4.6 percent, during 1997~2014. After adjustment by logistic regression for infantile sex, parity and maternal age, the odds ratio of PTB in birth year of 2012~14 was 1.38 (95% confidence interval: 1.36~1.39), compared with incidence of PTB in 1997~99. During the period, PTB rates increased 1.79 times in women aged 20~24 years and 25~29 years (OR: 1.56), whereas rates remained stable in women aged 35 years and older (OR: range from 1.08 to 1.13). 87.5% of the overall increase in the PTB rates was attributable to the increase in the proportion of women aged 30~34 years, but these age group accounted for only a small portion of the increase in PTB rates (OR: 1.27). CONCLUSION: The remainder of the total increment in the PTB rates during the period was explained by increase the proportion of women aged 30~34 years. There was a need to close attention in this area to understand the contributing factors to the secular trend of PTB rates.
Female ; Humans ; Incidence* ; Korea* ; Logistic Models ; Maternal Age* ; Multiple Birth Offspring ; Odds Ratio ; Parity ; Parturition* ; Premature Birth*

OBJECTIVETo analyze the trends of multiple births rates and their perinatal outcomes in Zhejiang province from 2008 to 2013.

METHODSData were obtained from hospital-based perinatal mortality surveillance system in Zhejiang, including all the hospitals in 30 monitoring counties (districts). All births (28 or more weeks of gestation) born in the monitoring hospitals were included in our study within 7 days after delivery from 2008 to 2013. Chi-square test was performed for statistical analyses for comparisons between regions. Trends in the incidence of multiple births and causes of perinatal death were analyzed using chi-square test for trend.

RESULTSFrom 2008 to 2013, the multiple births rate in Zhejiang province was increased and the rates were 2.32% (5 551/239 636), 2.49% (6 053/243 452), 2.61% (6 549/250 594), 2.82% (7 758/275 105), 2.91% (8 803/302 447) and 3.06% (9 051/295 709), respectively. And the perinatal mortality rates for multiple births were 4.32% (240/5 551), 3.45% (209/6 053), 3.76% (246/6 549), 2.86% (222/7 758), 2.77% (244/8 803) and 2.11% (191/9 051), respectively. A significant drop in the perinatal mortality rates for multiple births was observed between 2008 and 2013 (χ(2) trend = 66.52, P < 0.001). There was a significantly greater risk for perinatal death to multiple births when compared with single birth (OR = 3.62, 95% CI: 3.42-3.83). The three leading causes of perinatal death for multiple births were birth defect, premature and/or low birth weight, and twin-twin transfusion syndrome.

CONCLUSIONThe multiple births rates in Zhejiang province showed an increasing trend. The perinatal mortality rates for multiple births were decreased annually, however, it was still higher than those in developed countries.

China ; Congenital Abnormalities ; Female ; Fetofetal Transfusion ; Humans ; Incidence ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Multiple Birth Offspring ; Perinatal Mortality ; Pregnancy ; Pregnancy, Multiple ; Premature Birth

In order to investigate the risk factors of preterm delivery, we reviewed 1,676 birth cases excluding still-birth and multiple birth delivered at Seoul National University Hospital in 1995. The logistic regression analysis was used to examine the relationship between preterm birth and risk factors. The distribution of birth weight showed 9.7 % in low birth weight(< 2.5 kg), and 4.8 % in macrosomia(>or= 4.0 kg). The rate of preterm delivery was 9.2 %(155/1,676). The incidence of preterm delivery in maternal ages under 25(15.6 %) and above 35(14.3 %) was higher than that in 25~34 years old(7.9 %). There was a significant association between preterm birth and previous history of preterm birth, spontaneous abortion and induced abortion. There was no association between preterm birth and fetal sex or birth order. The risk for preterm birth was higher in nulliparous women aged 35 or older(OR : 2.521, 95% CI : 1.387-4.584, p < 0.001). There was a significant increase in preterm birth in women with following risk factors : previous history of preterm birth(OR : 3.616, CI : 2.138 - 6.118, p < 0.0001), history of spontaneous abortion(OR : 1.861, CI : 1.296-2.671, p < 0.0001), irregular menstrual cycle (OR : 2.174, CI : 1.469 - 3.215, p < 0.0001), and previous history of pregnancy complications(OR : 5.296, CI : 3.709 - 7.561, p < 0.0001). There was no significant increase in preterm birth in women with history of induced abortion(OR : 1.250, CI : 0.830 - 1.881, p = 0.2846).
Abortion, Induced ; Abortion, Spontaneous ; Birth Order ; Birth Weight ; Female ; Humans ; Incidence ; Logistic Models ; Maternal Age ; Menstrual Cycle ; Multiple Birth Offspring ; Parturition ; Pregnancy ; Premature Birth ; Risk Factors* ; Seoul