Triplet pregnancies – a three-decade perspective: do we fare better?

Weissman, Amir; Ulanovsky, Irena; Burke, Yechiel Z.; Makhoul, Imad R.; Blazer, Shraga; Drugan, Arie

doi:10.1016/j.ejogrb.2013.05.008

Cited by 18 publications

(36 citation statements)

References 11 publications

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“…In triplet pregnancies, the incidence of overall preterm deliveries is approximately 90%, with a risk of extreme preterm birth <28 weeks and very preterm birth 28-32 weeks 13-fold and almost 20-fold, respectively, when compared to singletons 4 . The rate of preterm births before 32 weeks of gestation in triplets is 3.3-fold higher than in twins and 24.1-fold higher than in singletons 3 .…”

Section: Introductionmentioning

confidence: 81%

“…The incidence of multiple gestations, particularly triplet and higher order pregnancies, has considerably increased over the past three decades, mainly due to the current widespread practice of assisted reproductive technology (ART), but also to the trend of delayed childbearing [1][2][3] . This increase in multiple gestations is known to cause concern in contemporary obstetrical practices because these pregnancies are known to be associated to poorer maternal and perinatal outcomes.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Triplet pregnancies: perinatal outcome evolution

Almeida¹,

Domingues²,

Belo³

et al. 2014

Rev. Bras. Ginecol. Obstet.

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Section: Introductionmentioning

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Triplet pregnancies: perinatal outcome evolution

Almeida¹,

Domingues²,

Belo³

et al. 2014

Rev. Bras. Ginecol. Obstet.

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“…Triplet pregnancies are rare, with a median of 0.3 per 1000 pregnancies in Europe in 2010, and these births are often excluded from analyses of very preterm births because there are too few cases in any given sample. Therefore, many questions arise regarding the optimal management of these pregnancies, including the optimal gestational age for delivery, mode of delivery, and the mortality and morbidity of triplet newborns . Using a large multiregional European cohort, this study therefore aimed to describe the characteristics, management, and outcomes of very preterm triplet pregnancies.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, many questions arise regarding the optimal management of these pregnancies, including the optimal gestational age for delivery, mode of delivery, and the mortality and morbidity of triplet newborns. 6,7 Using a large multiregional European cohort, this study therefore aimed to describe the characteristics, management, and outcomes of very preterm triplet pregnancies.…”

Section: Introductionmentioning

confidence: 99%

Characteristics, management and outcomes of very preterm triplets in 19 European regions

Dudenhausen

Misselwitz²,

Piedvache

et al. 2019

Intl J Gynecology & Obste

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Objective To describe obstetrical care and in‐hospital outcomes in very preterm triplet pregnancies in a European multiregional cohort. Methods Data from a prospective population‐based study of very preterm births between 22 + 0 and 31 + 6 weeks of gestation in 19 regions from 11 European countries participating in the EPICE project in 2011/2012 were used to describe triplet pregnancies and compare them with twins and singletons. Results Triplets constituted 1.1% of very preterm pregnancies (97/8851) and 3.3% of very preterm live births (258/7900); these percentages varied from 0% to 2.6% and 0% to 6% respectively across the regions. In‐hospital mortality after live birth was 12.4% and did not differ significantly from singletons or twins or by birth order. However, 28.9% of mothers with a triplet pregnancy experienced at least one neonatal death. Ninety percent of live‐born triplets were delivered by cesarean. Vaginal delivery was associated with an Apgar score of less than 7, but not with in‐hospital mortality. Conclusions The prevalence of very preterm triplets varies across European regions. Most triplets were born by cesarean and those born vaginally had lower Apgar scores. Overall, in‐hospital mortality after live birth was similar to singletons and twins.

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“…1–6 Triplets are admitted to a neonatal intensive care unit in 50–90% of cases, 4,7–9 compared with about 24% of twins and 3% of singletons. 10 Perinatal death occurs in 4.5–15% of triplets, 4,5,7,9,11–15 compared with 2.0% of twins and 0.45% of singletons. 2 Most of the excess neonatal morbidity and mortality among triplets is directly attributable to extremely preterm birth.…”

Section: Introductionmentioning

confidence: 99%

17‐Hydroxyprogesterone caproate in triplet pregnancy: an individual patient data meta‐analysis

Combs

Schuit

Caritis

et al. 2015

BJOG

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Background Preterm birth complicates almost all triplet pregnancies and no preventive strategy has proven effective. Objective To determine, using individual patient data (IPD) meta-analysis, whether the outcome of triplet pregnancy is affected by prophylactic administration of 17-hydroxyprogesterone caproate (17OHPc). Search strategy We searched literature databases, trial registries and references in published articles. Selection criteria Randomised controlled trials (RCTs) of progestogens versus control that included women with triplet pregnancies. Data collection and analysis Investigators from identified RCTs collaborated on the protocol and contributed their IPD. The primary outcome was a composite measure of adverse perinatal outcome. The secondary outcome was the rate of birth before 32 weeks of gestation. Other pre-specified outcomes included randomisation-to-delivery interval and rates of birth at < 24, < 28 and < 34 weeks of gestation. Main results Three RCTs of 17OHPc versus placebo included 232 mothers with triplet pregnancies and their 696 offspring. Risk-of-bias scores and between-study heterogeneity were low. Baseline characteristics were comparable between 17OHPc and placebo groups. The rate of the composite adverse perinatal outcome was similar among those treated with 17OHPc and those treated with placebo (34% and 35%, respectively; risk ratio [RR] 0.98, 95% confidence interval [95% CI] 0.74–1.3). The rate of birth at < 32 weeks was also similar in the two groups (35% and 38%, respectively; RR 0.92, 95% CI 0.55–1.56). There were no significant between-group differences in perinatal mortality rate, randomisation-to-delivery interval, or other specified outcomes. Conclusion Prophylactic 17OHPc given to mothers with triplet pregnancies had no significant impact on perinatal outcome or pregnancy duration. Tweetable abstract 17-Hydroxyprogesterone caproate had no significant impact on the outcome or duration of triplet pregnancy.

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Triplet pregnancies – a three-decade perspective: do we fare better?

Cited by 18 publications

References 11 publications

Triplet pregnancies: perinatal outcome evolution

Triplet pregnancies: perinatal outcome evolution

Characteristics, management and outcomes of very preterm triplets in 19 European regions

17‐Hydroxyprogesterone caproate in triplet pregnancy: an individual patient data meta‐analysis

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