Triplets are a relatively rare occurrence being encountered in the Maltese Islands with an overall incidence of about 0.1 per 1000 maternities. The incidence appears to be on the increase over the last twenty years rising from the 0.08 per 1000 maternities in the decade 1960-69 to 0.11 per 1000 maternities in the following two decades. This increase has been correlated with the increasing use of ovulation induction agents, as has the occurrence of two quadruplets and one octuplet pregnancies in 1988-90. Triplets are shown to occur more frequently in elderly mothers, but no relationship to parity could be identified. Higher order births are shown to have a high incidence of antenatal and intrapartum problems, and are associated with a higher fetal loss than singleton pregnancies.peer-reviewe
