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http://www.nytimes.com/2002/09/24/health/womenshealth/24RISK.html

At Risk: Multiple Births and Older Women

By ERIC NAGOURNEY

ultiple births are riskier than single ones. The same is true for pregnancies among older woman. So is it riskier still when both circumstances occur? Apparently not, researchers have found.

In a study published in this month's issue of Fertility and Sterility, researchers report that twins and triplets born to older mothers seem to have no greater risk of complications than do those born to younger ones. The triplets even tended to do better.

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The complications can include very premature birth, very low birth weight, miscarriages and death shortly after birth.

The study was conducted by researchers from the National Institute of Child Health and Human Development and the University of Kansas. The lead author was Dr. Jun Zhang. The report was based on an analysis of federal data for 147,000 twin pregnancies and 5,015 triplet ones over two years.

The findings may in part be another demonstration of the differing health care experiences of poor and better-off Americans.

Although older women are prone to having more difficult pregnancies, the researchers said, many of those carrying multiple babies become pregnant with the help of medical assistance like in-vitro fertilization or fertility drugs. This means they are likely to have more money or better health insurance, and to be educated and married, the study said. It also means that they are likely to have close medical supervision during pregnancy and after birth.

Beyond those advantages, assisted reproduction usually results in nonidentical twins or triplets, who are less susceptible to complications than are identical ones. They are also less likely to share a placenta or amniotic sac, the researchers said.

Moreover, when a donor egg is implanted, it usually comes from a young woman, also decreasing the odds of complications.

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ALL INFORMATION, DATA, AND MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR GENERAL INFORMATION PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE KNOWLEDGE OR OPINIONS OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED AS PROVIDING MEDICAL OR LEGAL ADVICE.  THE DECISION WHETHER OR NOT TO VACCINATE IS AN IMPORTANT AND COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU ALONE, IN CONSULTATION WITH YOUR HEALTH CARE PROVIDER.