Middlesex County Public Health Profile Report
Multiple Births: Percentage of Live Births, 2017-2019
Middlesex3.3% 95% Confidence IntervalNADescription of the Confidence IntervalThe confidence interval indicates the range of probable true values for the level of risk in the community.
A value of "NA" (Not Available) will appear if the confidence interval was not published with the NJSHAD indicator data for this measure.
State3.5% U.S.3.4%NA=Data not available.
Middlesex Compared to State
Description of Gauge
Description of the GaugeThis graphic is based on the county data to the left. It compares the county value of this indicator to the state overall value.
The county value is considered statistically significantly different from the state value if the state value is outside the range of the county's 95% confidence interval. If the county's data or 95% confidence interval information is not available, a blank gauge image will be displayed with the message, "missing information."NOTE: The labels used on the gauge graphic are meant to describe the county's status in plain language. The placement of the gauge needle is based solely on the statistical difference between the county and state values. When selecting priority health issues to work on, a county should take into account additional factors such as how much improvement could be made, the U.S. value, the statistical stability of the county number, the severity of the health condition, and whether the difference is clinically significant.
- Excellent = The county's value on this indicator is BETTER than the state value, and the difference IS statistically significant.
- Watch = The county's value is BETTER than state value, but the difference IS NOT statistically significant.
- Improvement Needed = The county's value on this indicator is WORSE than the state value, but the difference IS NOT statistically significant.
- Reason for Concern = The county's value on this indicator is WORSE than the state value, and the difference IS statistically significant.
Why Is This Important?There is a high risk of adverse outcome for multiple births.[https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2021/06/multifetal-gestations-twin-triplet-and-higher-order-multifetal-pregnancies ^1^] The outcomes are addressed in the respective indicator profiles.
How Are We Doing?Both the number and rate of multiple births generally increased through the 1990s and 2000s before beginning to decline after 2011. The vast majority (97%) of multiple births are twins. The number of triplets peaked in 1998 (at 467) and the proportion of multiples that are triplets is now less than one-third of what it was that year (2.9% and 10.1%, respectively).
Evidence-based PracticesThe American College of Obstetricians and Gynecologists' (ACOG) Committee on Ethics published an Opinion report in 2017 advising obstetrician-gynecologists (Ob/Gyns) to be knowledgeable about the medical risks of multifetal pregnancy, the potential medical benefits of multifetal pregnancy reduction, and the complex ethical issues inherent in decisions regarding multifetal pregnancy reduction. Multifetal pregnancies should be prevented whenever possible. When multifetal pregnancies do occur, incorporating the ethical framework presented in the Committee Opinion will help Ob/Gyns counsel and guide patients as they make decisions regarding continuing or reducing their multifetal pregnancies.[https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/09/multifetal-pregnancy-reduction ^3^]
Health Status Outcomes:
Data SourcesBirth Certificate Database, Office of Vital Statistics and Registry, New Jersey Department of Health
Measure Description for Multiple Births
Definition: Plurality is the number of all live births and pregnancy losses (miscarriages, ectopic pregnancies, fetal deaths, selective reductions) in a pregnancy. Multiple births are twins, triplets, quadruplets, and higher order births.
Numerator: Number of live births which were part of a multiple pregnancy (twin, triplet, etc.)
Denominator: Total number of live births