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  • Single Motherhood and Neonatal Survival of Twins



The neonatal period is very critical for infant survival and development. The increased vulnerability of the neonate is responsible for its lower survival threshold as compared to postneonates. In general, neonatal mortality rates are about twice the post-neonatal rates for nearly all racial/ethnic groups. Twin neonates are even more vulnerable than singletons. National rates of neonatal mortality for twins are elevated several-fold in comparison to rates observed among singleton gestations. Furthermore, twins account for 10-15% of the nation’s adverse neonatal outcomes, while only contributing to 2-3% of live births in the United States.

Infants born to unmarried mothers face higher risks for poor outcomes than those of married mothers. However, most of these studies have focused only on singleton births, and the effect of single motherhood on birth outcomes among twins remains poorly understood. This type of information is important because of two phenomena: 1) There has been a rise in childbearing by unmarried women in the United States averaging circa 6% (annually) in the 1980s and 1% (annually) in the 1990s; 2) Similarly, the rate of twinning has doubled over the last two decades. Given this background, it becomes important to investigate the impact of race and marital status on birth outcomes of twins. Accordingly, we sought to estimate the risk for neonatal mortality of twins born to single mothers among black and white gravidas in the United States.
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