Seeing double: a nation of twins from sea to shining sea.
n Dec. 23, 2015, the Division of Vital Statistics of the It was not until 1986 that the national twin birth rate began O National Centers for Health Statistics reported that the 2014 national twin birth rate reached an all time high of 33.9 per 1000 live births. The report went on to state that this latest record "was not significantly higher than the rate for 2013" but that it represented "a new high for the nation." The corresponding figure for non Hispanic black mothers stood at 40 per 1000 live births. The adverse consequences of a rising national twin birth rate cannot be overstated. Notably, 11% and 59% of the twins comprising the 2014 cohort were born "very preterm" 1 of every 2 twins born in 2014 was either preterm or low birthweight. A total of 18 states registered twin birth rates in excess of the overall national figure. New Jersey, Massachusetts, and Connecticut, all home to state mandated underwriting of infertility care, led the way with rates of 43.1, 42.8, and 40.5 per 1000 live births, respectively. The lowest twin birth rates were noted in Arizona, Arkansas, Oklahoma, and South Dakota (28.5, 28.8, 29.7, and 29.7 per 1000 live births, respectively) It is the purpose of this commentary to describe the ontogeny of the twin births "epidemic," define the forces that have shaped it, and highlight potential remedies.
American journal of obstetrics and gynecology