Prospective risk of stillbirth in multiple-gestation pregnancies: a population-based analysis.
OBJECTIVE
To evaluate the prospective risk of stillbirth in multiple gestations.


METHODS
We conducted a retrospective analysis of birth notifications and infant mortality records relating to all multiple gestations to residents in a predefined health district. The incidence of live births and stillbirths was used to calculate the prospective risk of stillbirth at each week of gestation.


RESULTS
The risk of stillbirth in multiple gestations increased from 1:3333 at 28 weeks' gestation to 1:69 at 39 or more weeks' gestation. The stillbirth risk in multiple gestations at 39 weeks surpassed that of postterm singleton pregnancies (1:526).


CONCLUSIONS
Multiple gestations at 37-38 weeks have a risk of stillbirth equivalent to that of postterm singleton pregnancy. Because multiple gestations rarely proceed beyond 39 weeks, and because stillbirth risk increases several-fold beyond this stage, elective delivery might be justified at this gestational age.
Sairam
Shanthi
S
Feto-Maternal Medicine Unit, Academic Department of Obstetrics and Gynaecology, St George's Hospital Medical School, London, United Kingdom.
Costeloe
Kate
K
Thilaganathan
Baskaran
B
D005260:Female; D005313:Fetal Death / Q000453:epidemiology*; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D008131:London / Q000453:epidemiology; D011247:Pregnancy; D011272:Pregnancy, Multiple; D011446:Prospective Studies; D012189:Retrospective Studies; D018570:Risk Assessment