This study aimed to examine differences in multiple maternities by neighborhood-income levels in Toronto, Canada.
Hospital records were used to perform secondary analysis of 144,731 maternities resulting in single or multiple infants live-born to mothers residing in the City of Toronto between 1996 and 2001. The independent variable was neighborhood income, defined as mean household neighborhood income quintiles. Multiple logistic regression analysis was used to compute adjusted odds ratios (AORs) and 95% confidence intervals (CIs).
Differences by income levels were found in twin maternities but not in higher-order maternities. Twin maternities were more likely to occur in the richest neighborhood-income quintile compared to the rest of the population (AOR: 1.25, 95% CI: 1.10-1.41), after adjustment for potential confounders.
The positive association between high neighborhood income and twin maternities found in this study suggests that the richest neighborhoods select families whose characteristics pose them at increased risk of having twins. Further studies are needed to clarify the underlying mechanisms leading to socioeconomic differences in multiple births.
Social determinants of health