Outcomes of quintuplet pregnancies

To review the obstetric and perinatal complications associated with quintuplet pregnancies in the United States.

The databases of two large support groups for higher order multiple gestations, the Triplet Connection and Mothers of Super Twins, were accessed for quintuplet pregnancies. Each record contained information regarding maternal demographics, obstetric complications and perinatal outcomes. The data were analyzed by the Student t test and chi 2 test as indicated, with a P value < .05 for significance.

Complete data were obtained for 36 quintuplet pregnancies. Preterm labor complicated all pregnancies. Six pregnancies delivered prior to 24 weeks' gestation, with no surviving infants. In the remaining 30 pregnancies, the mean gestational age at delivery was 28.9 weeks (SD +/- 2.0). There were trends toward later gestational ages at delivery in pregnancies with prophylactic cerclage placement and among multiparous women; however, these trends were not statistically significant. The perinatal mortality rate for the entire sample was 253/1,000. When adjusted for pregnancies delivered beyond 24 weeks' gestation, the perinatal mortality rate was 83/1,000. Minor and major neonatal morbidity affected 20% (26/132) and 10% (13/132) of quintuplet neonates, respectively.

Quintuplet pregnancies are associated with high rates of obstetric complications and significant perinatal morbidity and mortality.