Multiple Birth

Multiple births are the birth of more than one infant during a single delivery (twins, triplets, or higher-order births). Compared with singleton births (one infant), multiple births are at higher risk of adverse health outcomes for both the mother and the infants. For the mother, risks include gestational hypertension, gestational diabetes, and hemorrhage.24 For the infants, risks include preterm birth, low birthweight, birth defects, physical and mental disabilities, developmental delays, and death.24 Rates of multiple births vary by maternal race and Hispanic origin, and maternal age.

Figure 13: Rate of twin, triplet, and higher-order births by maternal race and Hispanic origin, 2016–2022
Rate of twin, triplet, and higher-order births by maternal race and Hispanic origin, 2016–2022

NOTE: NH = non-Hispanic origin; NHOPI = Native Hawaiian or Other Pacific Islander; AIAN = American Indian or Alaska Native. Race and Hispanic origin refer to the mother's race and Hispanic origin. The 1997 U.S. Office of Management and Budget standards for data on race and ethnicity were used to classify people into one of the following five racial groups: White, Black or African American, Asian, American Indian or Alaska Native, or Native Hawaiian or Other Pacific Islander. All categories are single race. Data on race and Hispanic origin are collected and reported separately. People of Hispanic origin may be of any race.

SOURCE: National Center for Health Statistics, National Vital Statistics System, Natality.

  • The total multiple birth rate decreased from 34 per 1,000 live births in 2016 to 32 per 1,000 in 2020 and then remained stable through 2022.
  • For American Indian or Alaska Native, non-Hispanic women, the multiple birth rate decreased from 2016 to 2020 and then increased from 2020 to 2022.
  • For Asian, non-Hispanic women, the rate decreased from 2016 to 2022.
  • For Black, non-Hispanic; Native Hawaiian or Other Pacific Islander, non-Hispanic; and Hispanic women, the multiple birth rate did not change significantly during the period.
  • For White, non-Hispanic women, the multiple birth rate decreased from 2016 to 2020 and then remained stable through 2022.
  • Throughout the period, Black, non-Hispanic women were the most likely to have a multiple birth.

Figure 14: Rate of twin, triplet, and higher-order births by maternal age group, 2016–2022
Rate of twin, triplet, and higher-order births by maternal age group, 2016–2022

SOURCE: National Center for Health Statistics, National Vital Statistics System, Natality.

  • For adolescents ages 15–19 and women ages 20–24 and 30–34, the multiple birth rate did not change significantly during the period.
  • For women ages 25–29, the multiple birth rate decreased from 2016 to 2022.
  • For women ages 35–39 and 40 and over, the multiple birth rate decreased from 2016 to 2020 and then remained stable through 2022.
  • Generally, the multiple birth rate increases with age. In 2022, the multiple birth rate was highest for women age 40 and over (40 per 1,000), followed by women ages 35–39 (39 per 1,000); 30–34 (35 per 1,000); 25–29 (30 per 1,000); 20–24 (24 per 1,000); and 15–19 (17 per 1,000).
  • Throughout the period, the multiple birth rate was generally higher for women age 40 and over compared with the other age groups.

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24 Elster, N. (2000). Less is more: the risks of multiple births. Fertility and Sterility, 74(4), 617–623. DOI: https://doi.org/10.1016/S0015-0282(00)00713-5.

Federal Interagency Forum on Child and Family Statistics

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