The association between multiple birth and infant mortality has been observed not only in developing countries [ 7- 14] but also in developed countries [ 15- 22].
However, the association between multiple birth and ASD in this study was weak and not statistically significant (Table 3, unadjusted odds ratio), whereas assisted reproduction technologies are strongly associated with multiple birth (23).
In particular, after adjusting for other known risk factors, there was a strong positive association between multiple birth defects and hospitalisation for pneumonia in the first 2 years of life in both Aboriginal (IRR = 5.0, 95% CI: 2.9, 8.6) and non-Aboriginal children (IRR = 6.0, 95% CI: 4.4, 8.2; Table 3).
21 22 They may face difficulties initiating lactation, because their ability to produce milk may be compromised by the preterm birth itself, 23 or by its association with obstetric (multiple birth, caesarean delivery) or maternal (eclampsia, admission to intensive care) complications.
Despite the small numbers of exposed cases for many of the early-life exposures, we were able to replicate many of the early-life findings from our previous analysis of white women with the exception of unique associations with monozygotic multiple birth status and maternal hypertensive disorder in black women.
We used multivariable logistic regression to examine the association between 28 day survival and transfer, and between transfer and multiple birth, with the inclusion of interaction terms to test whether the association differed between epochs.
TAMBA is an association, which registers and provides support to multiple birth families across the UK.
Our study of black women is the first to report a strong association between early-onset fibroid risk and multiple birth, specifically for having been part of a monozygotic multiple birth.
We also found an association with maternal hypertensive disorder that persisted after accounting for multiple birth status.
