LISTERIOSIS - A PREVIOUSLY UNREPORTED MEDICAL COMPLICATION IN WOMEN WITH MULTIPLE GESTATIONS

OBJECTIVE: Our purpose was to determine whether women pregnant with mu ltiple gestations are at greater risk for perinatal listeriosis than a re women pregnant with singletons. STUDY DESIGN: Active surveillance f or perinatal listeriosis was carried out in Los Angeles County, Califo rnia, medical records were reviewed, and rates of listeriosis were cal culated from live birth and fetal death data. RESULTS: From January 19 85 through December 1992, 12 (4.0%) of 301 perinatal listeriosis cases occurred in pregnant women with multiple gestations, almost four time s the overall multiple gestation rate in Los Angeles County. Fates of listeriosis in pregnant women per 100,000 live births and fetal deaths were 19.8 for singleton and 74.9 for multiple gestations (risk ratio 3.8, 95% confidence interval 2.1 to 6.8). Compared with singleton preg nancies, greater risk of listeriosis was observed in pregnancies with triplet gestations (risk ratio 38.4, 95% confidence interval 9.6 to 15 3.3) than in those with twin gestations (risk ratio 3.2, 95% confidenc e interval 1.7 to 6.0). Increased risk of listeriosis during multiple- gestation pregnancies was most notable among women greater than or equ al to 35 years (risk ratio 13.6, 95% confidence interval 5.2 to 35.5) and Hispanic women (risk ratio 5.3, 95% confidence interval 2.8 to 10. 0). CONCLUSIONS: To reduce the risk of listeriosis, obstetricians shou ld incorporate dietary recommendations into routine prenatal nutrition al counseling for all pregnant women and should especially counsel wom en pregnant with multiple gestations of their greater risk.