In this study, the temporal trends in the rates of multiple maternities in Denmark were analyzed and an association between the rates of multiple maternities and the socioeconomic variations in Denmark was obtained. The findings are compared with the results obtained in studies of Swedish rates. Obtained temporal differences in the twinning rates (TWRs) were similar to the results presented by Fellman and Eriksson (2014). Temporal variation in rates of multiple maternities in Sweden (1751–2000). JP Journal of Biostatistics, 11, 2, 143–156.

Using vital statistics, yearly changes in the twinning and triplet rates by zygosity were investigated in the Czech Republic and the Slovak Republic during the period 1972–1995. Monozygotic (MZ) twinning rates in both countries had remained nearly constant (about 3 per 1000 total births) during that period. With a few exceptions, the dizygotic (DZ) twinning rates remained constant from 1972 to 1994, and increased in 1995 for both countries. MZ twinning rates for both countries were the lowest in Europe. As for triplet rates, overall rates increased significantly year by year in the Czech Republic, but not in the Slovak Republic. The triplet rate was significantly higher in 1995 than in the period 1972–1982 for both countries. The MZ triplet rate remained constant during that period in the Czech Republic. The trizygotic (TZ) triplet rates increased 3-fold for the Czech Republic and 4-fold for the Slovak Republic in 1972–1976 and 1992–1995. In the later period, the TZ rate was 1.5-fold higher in the Czech Republic than in the Slovak Republic. The quadruplet rate increased 2.3-fold from 2.9 per million births in 1982–1986 to 6.7 in 1992–1995 in the Czech Republic. The corresponding values were 2.7, 2.20 and 5.9-fold in the Slovak Republic. Both the Czech and the Slovak Republics were not affected by fertility drugs and assisted reproductive techniques until recently.

Secular changes in twinning and triplet rates were analyzed using vital statistics in Austria, the Czech Republic, the Slovak Republic, England and Wales, Germany, the Netherlands, Switzerland, Denmark, Finland, Norway, Sweden, Canada, Australia, Hong Kong, Israel, Japan, and Singapore during the period from 1972 to 1996. Among those 17 countries, the twinning and triplet rates in the Czech Republic and in the Slovak Republic remained constant from 1972 to 1994, whereas these rates increased significantly year by year in the other 15 countries during the examined period in each country. Twinning rates increased from 1.2-fold in Austria to 2-fold in Denmark from 1972 to 1996. As for triplets, the rate increased from 3-fold in Denmark to 9-fold in Norway during that period. With one exception, that being the Slovak Republic, the triplet rate was highest in the Scandinavian countries, followed by the other European and Asian countries. The rising twinning and triplet rates have been attributed to the higher proportion of mothers treated with ovulation-inducing hormones and partially attributed to IVF.

Zygosity of triplet births in Japan was estimated by Allen's equation with the assumption that the rate of dizygotic (DZ) triplets reflects that of twins. Whereas the DZ triplet rate increased during the period from 1975 to 1994, reflecting the increase in the DZ twinning rate in the period, monozygotic (MZ) triplet rates remained constant from 1975 (28 per million births) to 1994 (23). The trizygotic (TZ) triplet rate gradually increased from 1975 (18) up to 1985 (29), and rapidly increased thereafter to 1994 (202). The higher TZ triplet rate since 1986 is most likely attributed to the higher proportion of mothers treated with ovulation-inducing hormones and partially to in-vitro fertilization in Japan. As for maternal age, MZ triplet rates remained nearly constant for all the maternal age groups except the youngest and the oldest ones. On the other hand, TZ triplet rates increased up to the age group of 30-34 years and decreased thereafter in almost every year. The TZ rate in the age group of 30-34 years slowly increased from 1975 to 1988 (63 per million births) and rapidly increased thereafter (314 in 1994). The TZ rate was statistically significantly higher in the period 1986-1994 than in the period 1975-1985 in each of the nine districts in Japan. Geographical variations in the TZ rates in the latest period have drastically changed from those during the period from 1955-1959 and in 1974.