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Triplet and Higher-Order Births in US Down 41%

The rate of triplet and higher-order births rose rapidly during the 1980s and 1990s, but that trend has ended.

According to a new report from the National Center for Health Statistics, the rate of triplet and higher-order births plunged 41 percent from 1998 to 2014. More than 90 percent of these births are triplets.

Almost all of the decline occurred among women 25 and older, particularly women 45 and older, a drop of 67 percent to 769.9 per 100,000 births from 2,326. Non-Hispanic white women had the largest drop, about 46 percent.

But rates of triplet or higher-order births were still 57 percent higher in this group than among non-Hispanic blacks, and more than twice as high as the rate among Hispanic women.

The decline was nationwide. Only Oklahoma and Louisiana had increases in the number of triplets, and even there the increases were small — 8 percent in Oklahoma and 4 percent in Louisiana.

Older mothers are more likely to have a multiple birth, and the increase before 1998 was largely attributed to rising average maternal age, according to the lead author, Joyce A. Martin, a statistician with the N.C.H.S.

“Age of mothers has continued to increase,” she said, “so you would expect the rate of triplets to increase. So the decline cannot be attributed to any changes in maternal age.”

“We think the decline is likely largely related to changes in fertility therapies, particularly assisted reproductive technology,” she added.

Fertility centers now are urged, for example, not to implant multiple embryos in women receiving treatment.

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