Multiple Births Multiply During Past Two Decades

November 13, 1997

There has been a remarkable rise in the number of triplet and other higher order multiple births over the past two decades. Up from 1,034 births in 1971 to 4,973 for 1995, the increase in higher order multiple births (triplets, quadruplets, and quintuplets) reflect the rising number of births to women in their thirties, who are more likely to have a multiple birth, and the use of fertility-enhancing drugs and techniques. Yet, babies born in triplet and other higher order multiple deliveries arrive smaller and earlier than single births and are at greater risk of infant death and lifelong health problems.

The number of live births in triplet deliveries tripled between 1980 (1,337) and 1995 and quadrupled since 1971. Over the last decade, increases in the number of triplet births averaged 11 percent a year. The ratio of triplet births per 100,000 births rose 272 percent between 1980 and 1995. In 1995 the 4,973 triplet and other higher order multiple births included 4,551 triplets, 365 quadruplets, and 57 quintuplets and greater births.

The major factor underlying the increase in triplet births appears to be the use of ovulation-enhancing drugs and assisted reproductive techniques, such as in vitro fertilization. Only one-third of this increase reflects the shift in maternal age, with more babies born to mothers in their thirties. Overall, increases in triplet births were most pronounced among married, college-educated mothers 30 years of age and over.

Massachusetts reported the highest triplet birth ratio for combined years 1992-94, more than twice as high as the Nation as a whole. Other States reporting ratios at least 50 percent higher than the U.S. as a whole were New Hampshire, New Jersey and Iowa. These States also tended to have a higher proportion of births to older, non-Hispanic white mothers.

Triplet births are at much greater risk than single births. Infant mortality rates are 12 times higher for these births than for single births. The average birth weight of a triplet newborn is only half that of a single birth and the period of gestation is, on average, 7 weeks shorter. For 1995, 92 percent of triplets were born preterm compared with just over 10 percent of births in single deliveries. Moreover, triplets are 12 times more likely to die within the first year of life.

Data on multiple births are based on data on 100 percent of the birth certificates registered in all States and the District of Columbia and reported to NCHS through the National Vital Statistics System.

For more information or for a copy of this report, contact:

NCHS Public Affairs Office
Phone: (301) 436-7551

Series 21, No. 55. Triplet Births: Trends and Outcomes, 1971-94. 22 pp. (PHS) 97-1933. pdf icon[PDF – 216 KB]

Report of Final Natality Statistics, 1995. Vol. 45, No. 11 supplement. 80 pp. (PHS) 97-1120 pdf icon[PDF – 826 KB]


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