Prevalence and outcome of higher-order multiples in Ilesa, Nigeria

Introduction: This study reviewed the current prevalence of higher-order multiples (HOMs) in our institution compared to earlier documentation in the 1970s. We also reviewed factors that influenced the observed changes. Materials and Methods: This retrospective study of HOM was conducted between January 2015 and December 2020. We reviewed case records of the parturient with HOM. We retrieved relevant information from the case records obtained from the central record department. Results: Eleven HOM (eight triplets and three quadruplets) out of the 4821 deliveries that occurred during the same period putting the prevalence at 0.23%. All the quadruplets were conceived via assisted reproductive technology. All the deliveries were through caesarean sections with no documented asphyxiated baby. There was a significant difference between the mean gestational age and mean birth weight at delivery (P = 0.029, P = 0.002) between the triplets and quadruplets' gestation, respectively. However, the mother's booking status and steroid administration did not significantly affect the foetal outcomes. There were three stillbirths in this review, and all were from the triplet gestation. Conclusion: The prevalence rate of HOM in this study is higher than that of the 1970s. Assisted reproductive technology (ART) contributed mainly to this increase. Good antenatal care and quick referral, and early presentation when complication ensues reduced perinatal morbidity and mortality.