Comparison of infant mortality among twins and singletons: United States 1960 and 1983

Joel C. Kleinman, Mary Glenn Fowler, Samuel S. Kessel

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77 Scopus citations


Infant mortality among US black and white twins and singletons was compared for 1960 and 1983 usIng the Linked Birth/Infant Death Data Sets from the National Center for Health Statistics. Both twin and singleton infant mortality rates showed impressive declines since 1960 but almost all of the improvement in survival for both twins and singletons was related to increased birth weight-specific survival rather than improved birth weight distribution. One-half of white twins and two-thirds of black twins weighed less than 2500 g at birth, and 9% of white twin births and 16% of black twin births were in the very low (<1, 500g) birth weight category. In 1983, twin infant mortality rates were still four to five times that of singletons. However, twins had a survival advantage in the 1250-3,000 g range, which persisted after adjustment for gestational age. Cause-specific mortality among twins was considerably higher for every major cause of death: twin mortality risks due to newborn respiratory disease, matemal causes, neonatal hemorrhage, and short gestation/low birth weight were six to 15 times that of singletons. The lowest twin-to-singleton mortality ratios observed were for congenital anomalies and sudden infant death syndrome with relative risks twice that of singletons. The data underscore the need to develop effective strategies to decrease infant mortality among twins. Am J Epidemiol 1991 ;133:133-43.

Original languageEnglish (US)
Pages (from-to)133-143
Number of pages11
JournalAmerican journal of epidemiology
Issue number2
StatePublished - Jan 15 1991
Externally publishedYes


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ASJC Scopus subject areas

  • Epidemiology


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