14 September 2023

Figures released today as part of the MBRRACE-UK Perinatal Mortality Surveillance Report in the UK reveal a concerning rise in stillbirths and neonatal deaths among pregnancies of twins, triplets or more. A particularly alarming statistic is that the neonatal death rate is now five times greater for someone who carried two or more babies than someone carrying one baby. The average neonatal death rate for all multiples in 2021 has increased by a third since 2019.

The report indicates perinatal mortality rates in the UK increased in 2021, ending a seven-year trend of yearly reductions.

The average neonatal death rate for someone carrying two or more babies is 8.10 per 1,000 births compared to 1.47 for a singleton pregnancy - more than five times greater. The average stillbirth rate for someone carrying two or more babies is 8.24 per 1,000 births compared to 3.41 for a singleton pregnancy, meaning a pregnancy is 2.4 times more likely to end in a stillbirth if a woman is carrying multiples.

The report highlights that across all pregnancies there are increases in stillbirth rates for babies born in the most deprived areas and for babies of black ethnicity. Neonatal mortality rates for babies born to mothers from the most deprived areas, and for babies of black, Asian and white ethnicity, are on the increase leading to sustained inequalities by both deprivation and ethnicity.

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Twins Trust represents families with twins, triplets and more, as well as people bereaved during or after a twin or triplet pregnancy. Shauna Leven, Chief Executive of Twins Trust, comments on the findings: 

"These findings are deeply concerning. For families expecting multiples, those currently experiencing neonatal care and for bereaved families, we know that the figures will be particularly stark. The findings will also be pertinent for people in black communities who are disproportionately impacted by stillbirths. 

"Maternity units need to act quickly to make sure that they are following NICE guidelines and delivering best practice care so that families having a multiple pregnancy can access the care that they need and deserve. Whilst systemic change takes time, progress is happening too slowly. Our community needs change to happen right now so that this trend is reversed."

Through a project funded by the Department of Health and Social Care, Twins Trust demonstrated through its Maternity Engagement Programme that adherence to NICE guidelines resulted in a 7% reduction in twin stillbirths and an 18% reduction in twin neonatal deaths. As a charity, we continue this important work and want to encourage healthcare professionals and parents alike to arm themselves with the information they need.


What can expectant parents do? 
  • Equip themselves with the right information - including an understanding of the NICE guidelines (NG137).
  • Understand the care that they should be receiving - read our care checklist.
  • Ask questions on any aspect of their care if unsure.
  • If something doesn't feel right within your pregnancy, get it checked out.
  • Take multiple-specific antenatal classes.


The full report is available to read on the MBRRACE-UK website.