J
Am J Obstet Gynecol. 1991 Jul;165(1):15-22.
Double jeopardy: twin infant mortality in the United
States, 1983 and 1984.
Fowler MG, Kleinman JC, Kiely JL, Kessel SS.
Division of Analysis, National Center for Health
Statistics, Hyattsville, MD 20782.
The United States Linked Birth/Infant Death Data Sets:
1983 and 1984 Birth Cohorts from the National Center for
Health Statistics were used to identify maternal and
infant characteristics related to twin infant mortality;
41,554 white and 10,062 black live-born matched twin
pairs were evaluated. Twin birth weight distribution was
skewed with 48% of white and 63% of black twins born
weighing less than 2500 gm. Overall infant mortality
rates were 47.1 and 79.3 deaths per 1000 live births for
white and black twins, respectively (five times the
rates for singletons). Three fourths of deaths were
among twins weighing less than 1500 gm. White
like-gender twins had about twice the risk of both twins
dying compared with unlike-gender twins. Likewise, white
twin pairs with greater than 25% birth weight disparity
had a 40% to 80% increased risk of both twins dying,
compared with twins whose weights were within 10% of
each other. Twins born to high-risk women (on the basis
of demographic factors) were twice as likely to die as
twins born to low-risk women. Thus strategies to
decrease twin infant mortality must address both
maternal and infant risk factors.
