Perinatal mortality in multiple pregnancies

BACKGROUND: The incidence of multiple pregnancies has increased over the last decade and hence the hospital stay and perinatal morbidity and mortality. OBJECTIVE: to know the perinatal mortality rate of multiple pregnancies treated in a regional hospital. MATERIAL AND METHODS: Retrospective study conducted from the hospital records of deaths that occurred from January 2002 to December 2007 at the Hospital Regional de Especialidades No. 23 IMSS, Monterrey, Nuevo Leon, Mexico. RESULTS: during the study period (six years) were 122,822 births and 95 were multiple pregnancies (0.77/1000 births): 81 (85%) of triplets, 11 (11%) of quadruplets, two of quintillizos and one sextillizos with a total of 303 newborns. 26% (25/95) of multiple pregnancies had one or more deaths. The perinatal mortality rate was 165/1000 births (50/303) compared with that of pregnancies with one fetus in the same period 14.5/1000 births (p<0.0001). 20.9% (17/81) of triplet pregnancies and 54.5% (6/11) of the four had one or more deaths (p<0.02), with a perinatal mortality rate of 131/1000 births (32/243) and 295/1000 births (13/44) (p<0.006), respectively. Only 2/10 (20%) of newborns in two pregnancies quintillizos died and 3/6 (50%) of a pregnancy sextillizos. There was no difference in the proportion of sexes, but in the average weight of newborns: the weight of the triplets was alive vs dead vs 1659 g 713 g (p<0.0001) and the quadruplets from 750 g vs 1341 g (p<0.0007), respectively. CONCLUSIONS: 26% of multiple pregnancies had one or more deaths and 15% of the neonates died (165/1000 births). Multiple pregnancies were complicated with one or more deaths at 20% of triplets, 54% of quadruplets and 100% of quintillizos. The perinatal mortality rate of pregnancies with multiple fetuses 3 and 4 was No. 131/1000 and No. 295/1000, respectively.