As reproductive technology – such as IVF and ovulation induction – has become more widespread, the number of resulting multiple birth pregnancies has increased. But success in one area spells public health concern in another, as multiple pregnancies pose higher health risks and inordinately high health care costs.
Researchers, who published their findings in the American Journal of Obstetrics & Gynecology, looked at costs of multiple and single-birth pregnancies and compared them using the Truven Health MarketScan Commercial Claims and Encounters Database.
While pregnancies with twins cost around five times more than singletons, the researchers note that triplet deliveries cost almost 20 times more than single births.
The investigators say that the increased cost was most likely to do with increased maternal morbidities, increased use of cesarean section and longer hospital stays.
“We also demonstrated increased mortality for both mothers and infants associated with multiple pregnancies, although the absolute rates were small,” says Dongmu Zhang, PhD, investigator from Merck & Co.
The Centers for Disease Control and Prevention (CDC) shows that in 2010,
The researchers note that although around 40% of twin births arise from reproductive technology, in births of triplets or more, that statistic increases to about 80%.
For the study, the researchers studied all women aged 19-45 years who delivered one or more baby between 2005 and 2010. This resulted in a study size of 437,924 delivery events, 97% of which were single births, while 2.85% were twins and 0.13% were triplets or more.
The team included medical expenses for mothers during the 27 weeks before delivery and 30 days after, as well as medical expenses for infants up to their first birthday.
Regarding the cost aspect of the study, Zhang says:
“By taking a broad approach, we have shown that medical expenses attributable to mothers and infants varied according to birth multiplicity.
For singleton pregnancy, maternal expenses accounted for about 60% of overall cost, whereas for twins or higher-order multiple births, expenses for infant care accounted for about 70% and 85% of total expenses, respectively.”
Overall, the adjusted total health care cost for singletons was around $21,000 per delivery, but the number for twins was $105,000 and over $400,000 for triplets or more.
The researchers say they accounted for co-existing conditions, such as hypertension, cardiovascular disease, diabetes, anemia and reproductive tract conditions.
Mothers of twins or more had “significantly higher” co-existing conditions than mothers of single babies, they say, and women with twins or triplets had higher mortality rates and longer hospital stays.
As a result, the team calls for strategies to reduce this health care burden.
They say that for women going through the IVF process, the multiple pregnancy risk occurs when there are multiple embryos transferred. So they recommend that doctors should consider strategies aimed at minimizing multiple embryo transfers.
Medical News Today recently reported that there has been an increase in IVF donors in the US, alongside better birth outcomes.