Prospective Risk of Stillbirth in Multiple-Gestation Pregnancies

In Brief OBJECTIVE To evaluate the prospective risk of stillbirth in multiple gestations. METHODS We conducted a retrospective analysis of birth notifications and infant mortality records relating to all multiple gestations to residents in a predefined health district. The incidence of live births and stillbirths was used to calculate the prospective risk of stillbirth at each week of gestation. RESULTS The risk of stillbirth in multiple gestations increased from 1:3333 at 28 weeks' gestation to 1:69 at 39 or more weeks' gestation. The stillbirth risk in multiple gestations at 39 weeks surpassed that of postterm singleton pregnancies (1:526). CONCLUSION Multiple gestations at 37–38 weeks have a risk of stillbirth equivalent to that of postterm singleton pregnancy. Because multiple gestations rarely proceed beyond 39 weeks, and because stillbirth risk increases severalfold beyond this stage, elective delivery might be justified at this gestational age. Risk of stillbirth in multiple gestations at 37–38 weeks' gestation is equivalent to that of postterm singleton pregnancy.