Special Considerations
Published online by Cambridge University Press: 11 October 2022
The rate of triplet and higher-order multiple (HOM) pregnancies increased more than 400% during the 1980s and 1990s, peaking at 193.5 per 100,000 births in 1998. The initial increased incidence has been attributed to two main factors, namely advanced maternal age at conception and the increased use of assisted reproductive technology (ART).1 However, with improved cryopreservation techniques in ART, the reduction in the number of embryos transferred with each cycle and the increase in the number of multifetal pregnancy reduction procedures, there was a decrease in the rate of triplet and HOM pregnancies to 93 per 100,000 births in 2018. This represents an 8% decline from the 2017 rate of 101.6 per 100,000 births and a 52% fall from the peak in 1998. In summary, the incidence of HOM pregnancy is decreasing but still present, so knowledge of the facts and issues remains essential for the maternal fetal medicine specialist.
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