Abstract

Infertility treatments have produced an increase in multiple gestations and premature deliveries. High-order multiple gestations have also increased. Clinicians are facing the challenge of managing these complicated pregnancies. The aim of this study was to analyse the factors of perinatal morbidity and mortality associated with high-order multiple pregnancy.

This was a retrospective study done upon on 51 cases of multiple pregnancies with 158 newborns, who were hospitalized at the national centre of reference for neonatology, the children’s hospital of Rabat, from September 1977 to August 2006. The anthropometric, clinical, therapeutic and outcome parameters were gathered then analysed.

We have recorded 46 triplet deliveries and 5 quadruplets. The perinatal mortality rate was 40.5 percent and the neonatal mortality rate was 12.7 percent. The incriminated factors were: respiratory despair (p⩽0.01), membrane hyalines illness (p⩽0.01), low birth weight (p⩽0.01), neonatal infection (p⩽0.01), childbirth place of delivery as well as way of delivery (p⩽0.01), and prematurity (p = 0.05).

High-order multiple pregnancy are pregnancies of high risk. Neonatal outcome will primarily depend on the birth weight of the babies, the conditions of delivery and the gestational age at delivery.