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QUESTION UNDER STUDY:\ud\udThe study has following objectives: 1) to determine the incidence of higher-order multiple births from 2005 to 2008 in Switzerland and its evolution over the last twenty years, and 2) to analyse the neonatal outcome and its change over the last two decades.\udMETHODS:\ud\udData on higher-order multiple births were retrospectively obtained from Swiss obstetric and neonatal hospitals and compared with results from the first two national surveys.\udRESULTS:\ud\udThe incidence of higher-order multiple births was 35.3/100,000 live births for triplets, 0.7/100,000 for quadruplets and 0.3/100,000 for quintuplets. All newborns were premature with a median gestational age of 32 1/7 weeks for triplets, 29 2/7 weeks for quadruplets and 28 4/7 weeks for quintuplets. 94% of triplets and all quadruplets and quintuplets survived the neonatal period. Over the last two decades, the incidence of quadruplet and quintuplet births has fallen, while that of triplet births has risen by 40%. The perinatal mortality of triplets has decreased and the neonatal morbidity, mainly respiratory distress, has remained constant.\udCONCLUSION:\ud\udHigher-order multiple births have a high morbidity that has not improved over the last two decades. The incidence of higher-order multiple births is still increasing, which demonstrates that reproductive medicine in Switzerland is not yet sufficiently controlled and monitored

Higher multiple births in Switzerland: neonatal outcome and evolution over the last 20 years