Effect of advanced maternal age on early mortality among quadruplets and quintuplets.

Abstract

This study was undertaken to determine whether advanced maternal age has an impact on survival among quadruplets and quintuplets. A retrospective cohort study was performed on 1 448 quadruplets and 180 quintuplets delivered in the United States between 1995 and 1997. Infants of older mothers (> or =35 years old) were compared with those of younger ones (<35 years old) in terms of early mortality indices. Adjusted mortality probabilities were computed by yearly intervals of maternal age. The likelihood for neonatal (odds ratio [OR]=2.00, 95% CI=1.20-3.45), perinatal (OR=2.10, 95% CI=1.32-3.23), and infant mortality (OR=2.13, 95% CI=1.28-3.60) was significantly higher among younger mothers. For each unit decrease in maternal age, the odds of stillbirth, neonatal, perinatal, and infant death went up by 9%, 12%, 13%, and 12%, respectively, in a dose-dependent fashion (P for trend <.0001). We found increasing maternal age to be associated with favorable survival outcomes among quadruplets and quintuplets.