Maternal morbidity and obstetric complications in triplet pregnancies and quadruplet and higher-order multiple pregnancies.
OBJECTIVE
The purpose of this study was to assess the risk of maternal morbidity and obstetric complications in women with triplet pregnancies and quadruplet and higher-order multiple pregnancies.


METHODS
We compared the outcomes in women with triplet pregnancies (n=5491) and quadruplet and higher-order multiple pregnancies (n=423) with women with twin pregnancies (n=152,238), with the use of the 1995 to 1997 Multiple Birth File of the United States.


RESULTS
After an adjustment was made for important confounding factors, the risks of pregnancy-associated hypertension and eclampsia, anemia, diabetes mellitus, abruptio placenta, premature rupture of membrane, and cesarean delivery were increased in women with triplet pregnancies and quadruplet and higher-order multiple gestations than in women with twin pregnancies. A dose-response relationship was observed for pregnancy-associated hypertension, diabetes mellitus, and placental abruption, with higher odds ratios in women with quadruplet and higher-order multiple gestations than in women with triplet pregnancies.


CONCLUSIONS
The risks of maternal morbidity and obstetric complications are increased in triplet pregnancies and quadruplet and higher-order multiple pregnancies than in twin pregnancies; for certain outcomes, there is a dose-response relationship.
OMNI Research Group, Department of Obstetrics and Gynecology and Ottawa Health Research Institute, University of Ottawa, Ottawa, Ontario, Canada. swwen@ohri.ca
Shi Wu
SW
Wen
Kitaw
K
Demissie
Qiuying
Q
Yang
Mark C
MC
Walker
D000037:Abruptio Placentae / Q000453:epidemiology; D000328:Adult; D000368:Aged; D015986:Confounding Factors, Epidemiologic; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D016015:Logistic Models; D008875:Middle Aged; D009017:Morbidity; D016017:Odds Ratio; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome; D011254:Pregnancy in Diabetics / Q000453:epidemiology; D011272:Pregnancy, Multiple; D011783:Quadruplets; D012189:Retrospective Studies; D018570:Risk Assessment; D014310:Triplets; D014427:Twins