Variations in multiple birth rates and impact on perinatal outcomes in Europe

Anna Heino; Mika Gissler; Ashna D. Hindori-Mohangoo; Béatrice Blondel; Kari Klungsøyr; Ivan Verdenik; Ewa Mierzejewska; Petr Velebil; Helga Sól Ólafsdóttir; Alison Macfarlane; Jennifer Zeitlin; Gerald Haidinger; Sophie Alexander; Pavlos Pavlou; Laust Mortensen; Luule Sakkeus; Nicholas Lack; Aris Antsaklis; Istvan Berbik; Sheelagh Bonham; Marina Cuttini; Janis Misins; Jone Jaselioniene; Yolande Wagener; Miriam Gatt; Jan Nijhuis; Karin Van Der Pal; Kari Klungsoyr; Katarzyna Szamotulska; Henrique Barros; Mihai Horga; Jan Cap; Natasa Tul Mandić; Francisco Bolúmar; Karin Gottvall; Sylvie Berrut; Jeannette Klimont; Wei Hong Zhang; Michèle Dramaix-Wilmet; Mélissa Van Humbeeck; Charlotte Leroy; Anne Frédérique Minsart; Virginie Van Leeuw; Evelyne Martens; Myriam De Spiegelaere; Freddy Verkruyssen; Michel Willems; Willem Aelvoet; Jean Tafforeau; Francoise Renard; Denise Walckiers; Deborah Cuignet; Philippe Demoulin; Heidi Cloots; Erik Hendrickx; Anne Kongs; Despina Stylianou; Theopisti Kyprianou; Nicos Skordes; Jens Langhoff Roos; Anne Marie Nybo Anderson; Laust Hvas Mortensen; Annukka Ritvanen; Marie Hélène Bouvier Colle; Anne Ego; Grégoire Rey; Guenther Heller; Anton Scharl; Peter Drakakis; Ragnheidur I. Bjarnadottir; Hildur Hardardóttir; Brynja Ragnarsdóttir; Vigdís Stefánsdóttir; Sigrídur Haraldsdóttir; Aisling Mulligan; Cristina Tamburini; Rosaria Boldrini; Sabrina Prati; Marzia Loghi; Cinzia Castagnaro; Stefano Marchetti; Alessandra Burgio; Monica Da Frè; Irisa Zile; Jelena Isakova; Rita Gaidelyte; Jone Jaselione; Audrey Billy; Aline Touvrey-Lecomte; Karin Van Der; Pal De Bruin; Peter Achterberg; Chantal Hukkelhoven; Ger De Winter; Anita Ravelli; Greta Rijninks-Van Driel; Pieter Tamminga; Martin Groesz; Patty Elferink-Stinkens; Arild Osen; Marta Ebbing; Sofia Correia; Alexandra Cucu; Živa Novak-Antolič; Mireia Jane; Maria Jose Vidal; Carmen Barona; Rosa Mas; Adela Recio Alcaide; Ellen Lundqvist; Claudia König; Monika Schmid; Nirupa Dattani; Jim Chalmers; Kirsten Monteath; Marie Climson; Leslie Marr; Rod Gibson; Gwyneth Thomas; Rhian Osborne; Russell Brown; David Sweet; Joanne Evans; Sinead Magill; Adele Graham; Heather Reid; Terry Falconer; Karen McConnell; Neil McComb

doi:10.1371/journal.pone.0149252

Variations in multiple birth rates and impact on perinatal outcomes in Europe

Anna Heino, Mika Gissler, Ashna D. Hindori-Mohangoo, Béatrice Blondel, Kari Klungsøyr, Ivan Verdenik, Ewa Mierzejewska, Petr Velebil, Helga Sól Ólafsdóttir, Alison Macfarlane, Jennifer Zeitlin, Gerald Haidinger, Sophie Alexander, Pavlos Pavlou, Laust Mortensen, Luule Sakkeus, Nicholas Lack, Aris Antsaklis, Istvan Berbik, Sheelagh BonhamMarina Cuttini, Janis Misins, Jone Jaselioniene, Yolande Wagener, Miriam Gatt, Jan Nijhuis, Karin Van Der Pal, Kari Klungsoyr, Katarzyna Szamotulska, Henrique Barros, Mihai Horga, Jan Cap, Natasa Tul Mandić, Francisco Bolúmar, Karin Gottvall, Sylvie Berrut, Jeannette Klimont, Wei Hong Zhang, Michèle Dramaix-Wilmet, Mélissa Van Humbeeck, Charlotte Leroy, Anne Frédérique Minsart, Virginie Van Leeuw, Evelyne Martens, Myriam De Spiegelaere, Freddy Verkruyssen, Michel Willems, Willem Aelvoet, Jean Tafforeau, Francoise Renard, Denise Walckiers, Deborah Cuignet, Philippe Demoulin, Heidi Cloots, Erik Hendrickx, Anne Kongs, Despina Stylianou, Theopisti Kyprianou, Nicos Skordes, Jens Langhoff Roos, Anne Marie Nybo Anderson, Laust Hvas Mortensen, Annukka Ritvanen, Marie Hélène Bouvier Colle, Anne Ego, Grégoire Rey, Guenther Heller, Anton Scharl, Peter Drakakis, Ragnheidur I. Bjarnadottir, Hildur Hardardóttir, Brynja Ragnarsdóttir, Vigdís Stefánsdóttir, Sigrídur Haraldsdóttir, Aisling Mulligan, Cristina Tamburini, Rosaria Boldrini, Sabrina Prati, Marzia Loghi, Cinzia Castagnaro, Stefano Marchetti, Alessandra Burgio, Monica Da Frè, Irisa Zile, Jelena Isakova, Rita Gaidelyte, Jone Jaselione, Audrey Billy, Aline Touvrey-Lecomte, Karin Van Der, Pal De Bruin, Peter Achterberg, Chantal Hukkelhoven, Ger De Winter, Anita Ravelli, Greta Rijninks-Van Driel, Pieter Tamminga, Martin Groesz, Patty Elferink-Stinkens, Arild Osen, Marta Ebbing, Sofia Correia, Alexandra Cucu, Živa Novak-Antolič, Mireia Jane, Maria Jose Vidal, Carmen Barona, Rosa Mas, Adela Recio Alcaide, Ellen Lundqvist, Claudia König, Monika Schmid, Nirupa Dattani, Jim Chalmers, Kirsten Monteath, Marie Climson, Leslie Marr, Rod Gibson, Gwyneth Thomas, Rhian Osborne, Russell Brown, David Sweet, Joanne Evans, Sinead Magill, Adele Graham, Heather Reid, Terry Falconer, Karen McConnell, Neil McComb

Ospedale Pediatrico Bambino Gesu

Research output: Contribution to journal › Article › peer-review

Abstract

Objective: Infants from multiple pregnancies have higher rates of preterm birth, stillbirth and neonatal death and differences in multiple birth rates (MBR) exist between countries. We aimed to describe differences in MBR in Europe and to investigate the impact of these differences on adverse perinatal outcomes at a population level. Methods: We used national aggregate birth data on multiple pregnancies, maternal age, gestational age (GA), stillbirth and neonatal death collected in the Euro-Peristat project (29 countries in 2010, N = 5 074 643 births). We also used European Society of Human Reproduction and Embryology (ESHRE) data on assisted conception and single embryo transfer (SET). The impact of MBR on outcomes was studied using meta-analysis techniques with randomeffects models to derive pooled risk ratios (pRR) overall and for four groups of country defined by their MBR. We computed population attributable risks (PAR) for these groups. Results: In 2010, the average MBR was 16.8 per 1000 women giving birth, ranging from 9.1 (Romania) to 26.5 (Cyprus). Compared to singletons, multiples had a nine-fold increased risk (pRR 9.4, 95% Cl 9.1-9.8) of preterm birth (

Original language	English
Article number	e0149252
Journal	PLoS One
Volume	11
Issue number	3
DOIs	https://doi.org/10.1371/journal.pone.0149252
Publication status	Published - Mar 1 2016

ASJC Scopus subject areas

Agricultural and Biological Sciences(all)
Biochemistry, Genetics and Molecular Biology(all)
Medicine(all)

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10.1371/journal.pone.0149252

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Heino, A., Gissler, M., Hindori-Mohangoo, A. D., Blondel, B., Klungsøyr, K., Verdenik, I., Mierzejewska, E., Velebil, P., Ólafsdóttir, H. S., Macfarlane, A., Zeitlin, J., Haidinger, G., Alexander, S., Pavlou, P., Mortensen, L., Sakkeus, L., Lack, N., Antsaklis, A., Berbik, I., ... McComb, N. (2016). Variations in multiple birth rates and impact on perinatal outcomes in Europe. PLoS One, 11(3), [e0149252]. https://doi.org/10.1371/journal.pone.0149252

Heino, A, Gissler, M, Hindori-Mohangoo, AD, Blondel, B, Klungsøyr, K, Verdenik, I, Mierzejewska, E, Velebil, P, Ólafsdóttir, HS, Macfarlane, A, Zeitlin, J, Haidinger, G, Alexander, S, Pavlou, P, Mortensen, L, Sakkeus, L, Lack, N, Antsaklis, A, Berbik, I, Bonham, S, Cuttini, M, Misins, J, Jaselioniene, J, Wagener, Y, Gatt, M, Nijhuis, J, Van Der Pal, K, Klungsoyr, K, Szamotulska, K, Barros, H, Horga, M, Cap, J, Mandić, NT, Bolúmar, F, Gottvall, K, Berrut, S, Klimont, J, Zhang, WH, Dramaix-Wilmet, M, Van Humbeeck, M, Leroy, C, Minsart, AF, Van Leeuw, V, Martens, E, De Spiegelaere, M, Verkruyssen, F, Willems, M, Aelvoet, W, Tafforeau, J, Renard, F, Walckiers, D, Cuignet, D, Demoulin, P, Cloots, H, Hendrickx, E, Kongs, A, Stylianou, D, Kyprianou, T, Skordes, N, Roos, JL, Anderson, AMN, Mortensen, LH, Ritvanen, A, Colle, MHB, Ego, A, Rey, G, Heller, G, Scharl, A, Drakakis, P, Bjarnadottir, RI, Hardardóttir, H, Ragnarsdóttir, B, Stefánsdóttir, V, Haraldsdóttir, S, Mulligan, A, Tamburini, C, Boldrini, R, Prati, S, Loghi, M, Castagnaro, C, Marchetti, S, Burgio, A, Da Frè, M, Zile, I, Isakova, J, Gaidelyte, R, Jaselione, J, Billy, A, Touvrey-Lecomte, A, Van Der, K, De Bruin, P, Achterberg, P, Hukkelhoven, C, De Winter, G, Ravelli, A, Rijninks-Van Driel, G, Tamminga, P, Groesz, M, Elferink-Stinkens, P, Osen, A, Ebbing, M, Correia, S, Cucu, A, Novak-Antolič, Ž, Jane, M, Vidal, MJ, Barona, C, Mas, R, Alcaide, AR, Lundqvist, E, König, C, Schmid, M, Dattani, N, Chalmers, J, Monteath, K, Climson, M, Marr, L, Gibson, R, Thomas, G, Osborne, R, Brown, R, Sweet, D, Evans, J, Magill, S, Graham, A, Reid, H, Falconer, T, McConnell, K & McComb, N 2016, 'Variations in multiple birth rates and impact on perinatal outcomes in Europe', PLoS One, vol. 11, no. 3, e0149252. https://doi.org/10.1371/journal.pone.0149252

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title = "Variations in multiple birth rates and impact on perinatal outcomes in Europe",

abstract = "Objective: Infants from multiple pregnancies have higher rates of preterm birth, stillbirth and neonatal death and differences in multiple birth rates (MBR) exist between countries. We aimed to describe differences in MBR in Europe and to investigate the impact of these differences on adverse perinatal outcomes at a population level. Methods: We used national aggregate birth data on multiple pregnancies, maternal age, gestational age (GA), stillbirth and neonatal death collected in the Euro-Peristat project (29 countries in 2010, N = 5 074 643 births). We also used European Society of Human Reproduction and Embryology (ESHRE) data on assisted conception and single embryo transfer (SET). The impact of MBR on outcomes was studied using meta-analysis techniques with randomeffects models to derive pooled risk ratios (pRR) overall and for four groups of country defined by their MBR. We computed population attributable risks (PAR) for these groups. Results: In 2010, the average MBR was 16.8 per 1000 women giving birth, ranging from 9.1 (Romania) to 26.5 (Cyprus). Compared to singletons, multiples had a nine-fold increased risk (pRR 9.4, 95% Cl 9.1-9.8) of preterm birth (",

author = "Anna Heino and Mika Gissler and Hindori-Mohangoo, {Ashna D.} and B{\'e}atrice Blondel and Kari Klungs{\o}yr and Ivan Verdenik and Ewa Mierzejewska and Petr Velebil and {\'O}lafsd{\'o}ttir, {Helga S{\'o}l} and Alison Macfarlane and Jennifer Zeitlin and Gerald Haidinger and Sophie Alexander and Pavlos Pavlou and Laust Mortensen and Luule Sakkeus and Nicholas Lack and Aris Antsaklis and Istvan Berbik and Sheelagh Bonham and Marina Cuttini and Janis Misins and Jone Jaselioniene and Yolande Wagener and Miriam Gatt and Jan Nijhuis and {Van Der Pal}, Karin and Kari Klungsoyr and Katarzyna Szamotulska and Henrique Barros and Mihai Horga and Jan Cap and Mandi{\'c}, {Natasa Tul} and Francisco Bol{\'u}mar and Karin Gottvall and Sylvie Berrut and Jeannette Klimont and Zhang, {Wei Hong} and Mich{\`e}le Dramaix-Wilmet and {Van Humbeeck}, M{\'e}lissa and Charlotte Leroy and Minsart, {Anne Fr{\'e}d{\'e}rique} and {Van Leeuw}, Virginie and Evelyne Martens and {De Spiegelaere}, Myriam and Freddy Verkruyssen and Michel Willems and Willem Aelvoet and Jean Tafforeau and Francoise Renard and Denise Walckiers and Deborah Cuignet and Philippe Demoulin and Heidi Cloots and Erik Hendrickx and Anne Kongs and Despina Stylianou and Theopisti Kyprianou and Nicos Skordes and Roos, {Jens Langhoff} and Anderson, {Anne Marie Nybo} and Mortensen, {Laust Hvas} and Annukka Ritvanen and Colle, {Marie H{\'e}l{\`e}ne Bouvier} and Anne Ego and Gr{\'e}goire Rey and Guenther Heller and Anton Scharl and Peter Drakakis and Bjarnadottir, {Ragnheidur I.} and Hildur Hardard{\'o}ttir and Brynja Ragnarsd{\'o}ttir and Vigd{\'i}s Stef{\'a}nsd{\'o}ttir and Sigr{\'i}dur Haraldsd{\'o}ttir and Aisling Mulligan and Cristina Tamburini and Rosaria Boldrini and Sabrina Prati and Marzia Loghi and Cinzia Castagnaro and Stefano Marchetti and Alessandra Burgio and {Da Fr{\`e}}, Monica and Irisa Zile and Jelena Isakova and Rita Gaidelyte and Jone Jaselione and Audrey Billy and Aline Touvrey-Lecomte and {Van Der}, Karin and {De Bruin}, Pal and Peter Achterberg and Chantal Hukkelhoven and {De Winter}, Ger and Anita Ravelli and {Rijninks-Van Driel}, Greta and Pieter Tamminga and Martin Groesz and Patty Elferink-Stinkens and Arild Osen and Marta Ebbing and Sofia Correia and Alexandra Cucu and {\v Z}iva Novak-Antoli{\v c} and Mireia Jane and Vidal, {Maria Jose} and Carmen Barona and Rosa Mas and Alcaide, {Adela Recio} and Ellen Lundqvist and Claudia K{\"o}nig and Monika Schmid and Nirupa Dattani and Jim Chalmers and Kirsten Monteath and Marie Climson and Leslie Marr and Rod Gibson and Gwyneth Thomas and Rhian Osborne and Russell Brown and David Sweet and Joanne Evans and Sinead Magill and Adele Graham and Heather Reid and Terry Falconer and Karen McConnell and Neil McComb",

year = "2016",

month = mar,

day = "1",

doi = "10.1371/journal.pone.0149252",

language = "English",

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T1 - Variations in multiple birth rates and impact on perinatal outcomes in Europe

AU - Heino, Anna

AU - Gissler, Mika

AU - Hindori-Mohangoo, Ashna D.

AU - Blondel, Béatrice

AU - Klungsøyr, Kari

AU - Verdenik, Ivan

AU - Mierzejewska, Ewa

AU - Velebil, Petr

AU - Ólafsdóttir, Helga Sól

AU - Macfarlane, Alison

AU - Zeitlin, Jennifer

AU - Haidinger, Gerald

AU - Alexander, Sophie

AU - Pavlou, Pavlos

AU - Mortensen, Laust

AU - Sakkeus, Luule

AU - Lack, Nicholas

AU - Antsaklis, Aris

AU - Berbik, Istvan

AU - Bonham, Sheelagh

AU - Cuttini, Marina

AU - Misins, Janis

AU - Jaselioniene, Jone

AU - Wagener, Yolande

AU - Gatt, Miriam

AU - Nijhuis, Jan

AU - Van Der Pal, Karin

AU - Klungsoyr, Kari

AU - Szamotulska, Katarzyna

AU - Barros, Henrique

AU - Horga, Mihai

AU - Cap, Jan

AU - Mandić, Natasa Tul

AU - Bolúmar, Francisco

AU - Gottvall, Karin

AU - Berrut, Sylvie

AU - Klimont, Jeannette

AU - Zhang, Wei Hong

AU - Dramaix-Wilmet, Michèle

AU - Van Humbeeck, Mélissa

AU - Leroy, Charlotte

AU - Minsart, Anne Frédérique

AU - Van Leeuw, Virginie

AU - Martens, Evelyne

AU - De Spiegelaere, Myriam

AU - Verkruyssen, Freddy

AU - Willems, Michel

AU - Aelvoet, Willem

AU - Tafforeau, Jean

AU - Renard, Francoise

AU - Walckiers, Denise

AU - Cuignet, Deborah

AU - Demoulin, Philippe

AU - Cloots, Heidi

AU - Hendrickx, Erik

AU - Kongs, Anne

AU - Stylianou, Despina

AU - Kyprianou, Theopisti

AU - Skordes, Nicos

AU - Roos, Jens Langhoff

AU - Anderson, Anne Marie Nybo

AU - Mortensen, Laust Hvas

AU - Ritvanen, Annukka

AU - Colle, Marie Hélène Bouvier

AU - Ego, Anne

AU - Rey, Grégoire

AU - Heller, Guenther

AU - Scharl, Anton

AU - Drakakis, Peter

AU - Bjarnadottir, Ragnheidur I.

AU - Hardardóttir, Hildur

AU - Ragnarsdóttir, Brynja

AU - Stefánsdóttir, Vigdís

AU - Haraldsdóttir, Sigrídur

AU - Mulligan, Aisling

AU - Tamburini, Cristina

AU - Boldrini, Rosaria

AU - Prati, Sabrina

AU - Loghi, Marzia

AU - Castagnaro, Cinzia

AU - Marchetti, Stefano

AU - Burgio, Alessandra

AU - Da Frè, Monica

AU - Zile, Irisa

AU - Isakova, Jelena

AU - Gaidelyte, Rita

AU - Jaselione, Jone

AU - Billy, Audrey

AU - Touvrey-Lecomte, Aline

AU - Van Der, Karin

AU - De Bruin, Pal

AU - Achterberg, Peter

AU - Hukkelhoven, Chantal

AU - De Winter, Ger

AU - Ravelli, Anita

AU - Rijninks-Van Driel, Greta

AU - Tamminga, Pieter

AU - Groesz, Martin

AU - Elferink-Stinkens, Patty

AU - Osen, Arild

AU - Ebbing, Marta

AU - Correia, Sofia

AU - Cucu, Alexandra

AU - Novak-Antolič, Živa

AU - Jane, Mireia

AU - Vidal, Maria Jose

AU - Barona, Carmen

AU - Mas, Rosa

AU - Alcaide, Adela Recio

AU - Lundqvist, Ellen

AU - König, Claudia

AU - Schmid, Monika

AU - Dattani, Nirupa

AU - Chalmers, Jim

AU - Monteath, Kirsten

AU - Climson, Marie

AU - Marr, Leslie

AU - Gibson, Rod

AU - Thomas, Gwyneth

AU - Osborne, Rhian

AU - Brown, Russell

AU - Sweet, David

AU - Evans, Joanne

AU - Magill, Sinead

AU - Graham, Adele

AU - Reid, Heather

AU - Falconer, Terry

AU - McConnell, Karen

AU - McComb, Neil

PY - 2016/3/1

Y1 - 2016/3/1

N2 - Objective: Infants from multiple pregnancies have higher rates of preterm birth, stillbirth and neonatal death and differences in multiple birth rates (MBR) exist between countries. We aimed to describe differences in MBR in Europe and to investigate the impact of these differences on adverse perinatal outcomes at a population level. Methods: We used national aggregate birth data on multiple pregnancies, maternal age, gestational age (GA), stillbirth and neonatal death collected in the Euro-Peristat project (29 countries in 2010, N = 5 074 643 births). We also used European Society of Human Reproduction and Embryology (ESHRE) data on assisted conception and single embryo transfer (SET). The impact of MBR on outcomes was studied using meta-analysis techniques with randomeffects models to derive pooled risk ratios (pRR) overall and for four groups of country defined by their MBR. We computed population attributable risks (PAR) for these groups. Results: In 2010, the average MBR was 16.8 per 1000 women giving birth, ranging from 9.1 (Romania) to 26.5 (Cyprus). Compared to singletons, multiples had a nine-fold increased risk (pRR 9.4, 95% Cl 9.1-9.8) of preterm birth (

AB - Objective: Infants from multiple pregnancies have higher rates of preterm birth, stillbirth and neonatal death and differences in multiple birth rates (MBR) exist between countries. We aimed to describe differences in MBR in Europe and to investigate the impact of these differences on adverse perinatal outcomes at a population level. Methods: We used national aggregate birth data on multiple pregnancies, maternal age, gestational age (GA), stillbirth and neonatal death collected in the Euro-Peristat project (29 countries in 2010, N = 5 074 643 births). We also used European Society of Human Reproduction and Embryology (ESHRE) data on assisted conception and single embryo transfer (SET). The impact of MBR on outcomes was studied using meta-analysis techniques with randomeffects models to derive pooled risk ratios (pRR) overall and for four groups of country defined by their MBR. We computed population attributable risks (PAR) for these groups. Results: In 2010, the average MBR was 16.8 per 1000 women giving birth, ranging from 9.1 (Romania) to 26.5 (Cyprus). Compared to singletons, multiples had a nine-fold increased risk (pRR 9.4, 95% Cl 9.1-9.8) of preterm birth (

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U2 - 10.1371/journal.pone.0149252

DO - 10.1371/journal.pone.0149252

M3 - Article

AN - SCOPUS:84961839072

SN - 1932-6203

VL - 11

JO - PLoS One

JF - PLoS One

IS - 3

M1 - e0149252

ER -

Variations in multiple birth rates and impact on perinatal outcomes in Europe

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