Compared to in vitro fertilization (IVF) with autologous oocytes and to spontaneous pregnancies, oocyte donation (OD) pregnancies are at increased risk for pregnancy induced hypertension (PIH) and cesarean delivery. Data regarding perinatal outcomes of OD pregnancies are inconsistent. Data regarding triplets are scarce. This study compares maternal and neonatal risks of OD pregnancies in singleton, twins, and triplets, to those of IVF with autologous oocytes and to spontaneous pregnancies.