{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T16:45:16Z","timestamp":1768927516180,"version":"3.49.0"},"reference-count":42,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2013,2,6]],"date-time":"2013-02-06T00:00:00Z","timestamp":1360108800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2013,5]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the public health consequences of the rise in multiple births with respect to congenital anomalies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Descriptive epidemiological analysis of data from population\u2010based congenital anomaly registries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Fourteen European countries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>A total of 5.4 million births 1984\u20132007, of which 3% were multiple births.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Cases of congenital anomaly included live births, fetal deaths from 20\u00a0weeks of gestation and terminations of pregnancy for fetal anomaly.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Prevalence rates per 10\u00a0000 births and relative risk of congenital anomaly in multiple versus singleton births (1984\u20132007); proportion prenatally diagnosed, proportion by pregnancy outcome (2000\u201307). Proportion of pairs where both co\u2010twins were cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Prevalence of congenital anomalies from multiple births increased from 5.9 (1984\u201387) to 10.7 per 10\u00a0000 births (2004\u201307). Relative risk of nonchromosomal anomaly in multiple births was 1.35 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.31\u20131.39), increasing over time, and of chromosomal anomalies was 0.72 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.65\u20130.80), decreasing over time. In 11.4% of affected twin pairs both babies had congenital anomalies (2000\u201307). The prenatal diagnosis rate was similar for multiple and singleton pregnancies. Cases from multiple pregnancies were less likely to be terminations of pregnancy for fetal anomaly, odds ratio 0.41 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.35\u20130.48) and more likely to be stillbirths and neonatal deaths.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The increase in babies who are both from a multiple pregnancy and affected by a congenital anomaly has implications for prenatal and postnatal service provision. The contribution of assisted reproductive technologies to the increase in risk needs further research. The deficit of chromosomal anomalies among multiple births has relevance for prenatal risk counselling.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.12146","type":"journal-article","created":{"date-parts":[[2013,1,31]],"date-time":"2013-01-31T13:50:25Z","timestamp":1359640225000},"page":"707-716","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":61,"title":["Trends in the prevalence, risk and pregnancy outcome of multiple births with congenital anomaly: a registry\u2010based study in 14 <scp>E<\/scp>uropean countries 1984\u20132007"],"prefix":"10.1111","volume":"120","author":[{"given":"B","family":"Boyle","sequence":"first","affiliation":[{"name":"Centre for Maternal Fetal and Infant Research University of Ulster Newtownabbey UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R","family":"McConkey","sequence":"additional","affiliation":[{"name":"Centre for Intellectual and Developmental Disabilities University of Ulster Newtownabbey UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E","family":"Garne","sequence":"additional","affiliation":[{"name":"Hospital Lillebaelt Kolding Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Loane","sequence":"additional","affiliation":[{"name":"Centre for Maternal Fetal and Infant Research University of Ulster Newtownabbey UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"MC","family":"Addor","sequence":"additional","affiliation":[{"name":"Division of Medical Genetics Lausanne Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"MK","family":"Bakker","sequence":"additional","affiliation":[{"name":"Eurocat Northern Netherlands Department of Genetics University of Groningen University Medical Center Groningen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"PA","family":"Boyd","sequence":"additional","affiliation":[{"name":"National Perinatal Epidemiology Unit University of Oxford Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Gatt","sequence":"additional","affiliation":[{"name":"Department of Health Information and Research Guardamangia Malta"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R","family":"Greenlees","sequence":"additional","affiliation":[{"name":"Centre for Maternal Fetal and Infant Research University of Ulster Newtownabbey UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Haeusler","sequence":"additional","affiliation":[{"name":"Medical University of Graz Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K","family":"Klungs\u00f8yr","sequence":"additional","affiliation":[{"name":"Medical Birth Registry of Norway Bergen Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Latos\u2010Bielenska","sequence":"additional","affiliation":[{"name":"Polish Registry of Congenital Malformations Poznan Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N","family":"Lelong","sequence":"additional","affiliation":[{"name":"Paris Registry of Congenital Malformations INSERM U953 Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R","family":"McDonnell","sequence":"additional","affiliation":[{"name":"Health Service Executive Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"M\u00e9tneki","sequence":"additional","affiliation":[{"name":"National Institute of Health Development Department of Hungarian Congenital Abnormality Registry &amp; 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