{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T20:08:49Z","timestamp":1785528529706,"version":"3.56.0"},"reference-count":21,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2003,10,14]],"date-time":"2003-10-14T00:00:00Z","timestamp":1066089600000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Birth Defects Research"],"published-print":{"date-parts":[[2003,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Multiple births are increasing, and may be associated with birth defects.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>To explore this relationship, data from the Virginia birth defects registry (VaCARES) was analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>During 1989\u20131998, a total of 44,505 children from singleton births and 2258 children from multiple births were born with birth defects in Virginia. The risk of birth defects was significantly increased in children from multiple births as compared to singleton births (birth defect rate per 10,000 live births: singleton 482.3, twin 922.0, triplet 1300.0, and quadruplet or higher 2222.2). Increased risk was observed for 39 of 86 diagnoses. The five diagnoses with the highest risk ratio per 10,000 live births (RR) were: neurofibromatosis (RR, 12.80), retrolental fibroplasia (RR, 9.96), microphthalmos (RR, 5.24), pulmonary valve anomalies (RR, 5.00), and patent ductus arteriosus (RR, 4.68). A significantly reduced risk ratio for congenital hip dislocation was found in these children (RR, 0.54). In most multiple births, only one child was born with birth defects (81% in twin births, 71% in triplet births, and 56% in quadruplet and higher births). The diagnosis of birth defects might be concordant or discordant for children in which all siblings had birth defects. The children from multiple births who had birth defects were generally preterm and had significantly lower birth weight. A higher fatality and mortality rate and longer hospital stay were also observed.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Overall, children from multiple births have an increased risk of birth defects. Birth Defects Research (Part A) 67:879\u2013885, 2003. \u00a9 2003 Wiley\u2010Liss, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bdra.10093","type":"journal-article","created":{"date-parts":[[2003,10,17]],"date-time":"2003-10-17T12:00:12Z","timestamp":1066392012000},"page":"879-885","source":"Crossref","is-referenced-by-count":76,"title":["Increased risk of birth defects among children from multiple births"],"prefix":"10.1002","volume":"67","author":[{"given":"Si\u2010Jia","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Ford","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Meister","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joann","family":"Bodurtha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2003,10,14]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199407283310407"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0028-2243(83)90011-4"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0001566000000854"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0001566000002403"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/11.suppl_4.110"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/jech.45.1.43"},{"key":"e_1_2_6_8_1","first-page":"345","article-title":"Fetal deaths with birth defects among Japanese multiples, 1974","volume":"39","author":"Imaizumi Y","year":"1990","journal-title":"Acta Genet Med Gemellol (Roma)"},{"key":"e_1_2_6_9_1","first-page":"253","article-title":"Multiple births and congenital anomalies in Tokyo metropolitan hospitals, 1979\u20131990","volume":"41","author":"Kato K","year":"1991","journal-title":"Acta Genet Med Gemellol (Roma)"},{"key":"e_1_2_6_10_1","volume-title":"Virginia congenital anomalies reporting and education system: birth defect surveillance data 1989\u20131998","author":"Li S\u2010J","year":"2003"},{"key":"e_1_2_6_11_1","first-page":"507","article-title":"An agenda for meeting the special needs of multiple birth families","volume":"39","author":"Malmstrom PM","year":"1990","journal-title":"Acta Genet Med Gemellol (Roma)"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-8628(19990312)83:2<117::AID-AJMG7>3.0.CO;2-4"},{"key":"e_1_2_6_13_1","first-page":"1171","article-title":"Temporal trends in the incidence of birth defects\u2014United States. MMWR","volume":"46","author":"MMWR","year":"1997","journal-title":"Morb Mortal Wkly Rep"},{"key":"e_1_2_6_14_1","first-page":"289","article-title":"Impact of multiple births on low birth weight\u2014Massachusetts, 1989\u20131996. MMWR","volume":"48","author":"MMWR","year":"1999","journal-title":"Morb Mortal Wkly Rep"},{"key":"e_1_2_6_15_1","first-page":"1","article-title":"Congenital malformations in twins: epidemiologic survey","volume":"11","author":"Myrianthopoulos NC","year":"1975","journal-title":"Birth Defects Orig Artic Ser"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0001566000014380"},{"key":"e_1_2_6_17_1","first-page":"158","article-title":"Congenital malformations in twins","volume":"127","author":"Nazer J","year":"1999","journal-title":"Rev Med Chil"},{"key":"e_1_2_6_18_1","first-page":"221","article-title":"Discordant congenital malformations in monozygous twins: the amniotic band disruption complex","volume":"2","author":"Pysher TJ","year":"1980","journal-title":"Diagn Gynecol Obstet"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0001566000003524"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1067\/mpd.2000.105132"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0001566000007558"},{"key":"e_1_2_6_22_1","first-page":"255","article-title":"Prevalence and forms of congenital anomalies in twins born in Pomeranian District during the period from 1.07.1997 to 31.12.1998. Polish Register of Congenital Anomalies","volume":"47","author":"Zimon T","year":"1998","journal-title":"Acta Genet Med Gemellol (Roma)"}],"container-title":["Birth Defects Research Part A: Clinical and Molecular Teratology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fbdra.10093","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/bdra.10093","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T23:50:29Z","timestamp":1696981829000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/bdra.10093"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2003,10]]},"references-count":21,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2003,10]]}},"alternative-id":["10.1002\/bdra.10093"],"URL":"https:\/\/doi.org\/10.1002\/bdra.10093","archive":["Portico"],"relation":{},"ISSN":["1542-0752","1542-0760"],"issn-type":[{"value":"1542-0752","type":"print"},{"value":"1542-0760","type":"electronic"}],"subject":[],"published":{"date-parts":[[2003,10]]}}}