Are neonatal outcomes of triplet pregnancies different from those of singletons according to gestational age?
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Georgios Mitsiakos
,
Dimitra Gialamprinou
Abstract
Objectives
Multiple pregnancies sustain the high pace of extreme prematurity. Little evidence is available about triplet gestation given the evolution in their management during the last decades. The aim of the study was to compare the neonatal outcomes of triplets with those of matched singletons in a cohort study.
Methods
An observational retrospective cohort study of triplets and matched singletons born between 2004 and 2017 matched by gestational age was conducted. Additionally, the investigation performed in regard to data from the overall Greek population of interest. The primary outcome was mortality or severe neonatal morbidity based on pregnancy type.
Results
A total of 237 triplets of 24–36 weeks’ gestation and 482 matched singletons were included. No differences in the primary outcome between triplets and singletons were found. Rates of severe neonatal morbidities did not differ significantly between triplets and singletons. A threshold of 1000 gr for birthweight and 28 weeks’ gestation for gestational age determined survival on triplets [OR: 0.08 (95% CI: 0.02–0.40, p=0.0020) and OR: 0.13 (95% CI: 0.03–0.57, p=0.0020) for gestational age and birthweight respectively]. In Greece stillbirths in triplets was 8 times higher than that of singletons (OR: 8.5, 95% CI: 6.9–10.5). From 3,375 triplets, 94 were stillborn, whereas in singletons, 4,659 out of 1,388,273. In our center 5 times more triplets than the expected average in Greece were delivered with no significant difference in stillbirths’ rates.
Conclusions
No significant differences were identified in mortality or major neonatal morbidities between triplets and matched singletons highlighting the significance of prematurity and birthweight for these outcomes.
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Research funding: None declared.
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Author contribution: Georgios Mitsiakos: Had primary responsibility for conceptualization of this work and protocol development, had responsibility for analysis/interpretation of data and writing and critically revising the manuscript. Dimitra Gialamprinou: Had responsibility for conceptualization of the work, acquisition, analysis/interpretation of data and writing and critically revising the manuscript. Ilias Chatziioannidis: Had contributed to patient enrolment, interpretation of data and had critically reviewing the manuscript. Abraham Pouliakis: Performed the statistical analysis of the data and had critically revising the manuscript. Christos Georgios Kontovazainitis: Performed the statistical analysis of the data, contributed to patient enrolment and had critically reviewing the manuscript. Fotini Chatzigrigoriou: Contributed to patient enrollment and acquisition of data and had critically reviewing the manuscript. Anastasia Karagkiozi: Contributed to patient enrollment and acquisition of data and had critically reviewing the manuscript. Eleni Lazaridou: Contributed to patient enrollment and acquisition of data and had critically reviewing the manuscript. Efthimia Papacharalambous: Contributed to patient enrollment and acquisition of data and had critically reviewing the manuscript. Effimia Poumpouridou: Contributed to patient enrollment and acquisition of data and had critically reviewing the manuscript. Theodoros Theodoridis: Interpretation of data and had critically reviewing the manuscript. Evgenyia Babacheva: Interpretation of data and had critically reviewing the manuscript. Paraskevi Karagianni: Interpretation of data and had critically reviewing the manuscript. Grigorios Grimbizis: Interpretation of data and had critically reviewing the manuscript. Vassiliki Soubasi: Interpretation of data and had critically reviewing the manuscript. All authors critically revised the manuscript and approved the final version to be submitted. Especially, all authors revised the draft in terms of ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
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Competing interests: Authors state no conflict of interest.
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Informed consent: Not applicable.
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Ethical approval: This study protocol was approved by the local Ethics Committee and was conducted under protocol number not requiring parents’ informed consent.
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© 2021 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Review
- Global incidence of intraventricular hemorrhage among extremely preterm infants: a systematic literature review
- Commentary
- Professional integrity in maternal – fetal innovation and research: an essential component of perinatal medicine
- WAPM Recommendations
- WAPM-World Association of Perinatal Medicine Practice Guidelines: Fetal central nervous system examination
- Corner of Academy
- Education in developing countries and reducing maternal mortality: a forgotten piece of the puzzle?
- Original Articles – Obstetrics
- The contemporary value of dedicated preterm birth clinics for high-risk singleton pregnancies: 15-year outcomes from a leading maternal centre
- Chorioamnionitis after premature rupture of membranes in nulliparas undergoing labor induction: prostaglandin E2 vs. oxytocin
- Maternal and fetal outcomes in pregnancies with obstructive sleep apnea
- Assessing the involvement of the placental microbiome and virome in preeclampsia using non coding RNA sequencing
- Risk of metformin failure in the treatment of women with gestational diabetes
- Can we improve our ability to interpret category II fetal heart rate tracings using additional clinical parameters?
- New obstetric systemic inflammatory response syndrome criteria for early identification of high-risk of sepsis in obstetric patients
- Bacteria in the amniotic fluid without inflammation: early colonization vs. contamination
- Intertwin differences in umbilical artery pulsatility index are associated with infant survival in twin-to-twin transfusion syndrome
- Maternal and neonatal outcomes in women with disorders of lipid metabolism
- The use of PAMG-1 testing in patients with preterm labor, intact membranes and a short sonographic cervix reduces the rate of unnecessary antenatal glucocorticoid administration
- Original Articles – Neonates
- The effect of postnatal corticosteroids on growth parameters in infants with bronchopulmonary dysplasia
- Are neonatal outcomes of triplet pregnancies different from those of singletons according to gestational age?
- Impact of paternal presence and parental social-demographic characteristics on birth outcomes
- Letter to the Editor
- Comment on: “amniotic fluid embolism – implementation of international diagnosis criteria and subsequent pregnancy recurrence risk”
Articles in the same Issue
- Frontmatter
- Review
- Global incidence of intraventricular hemorrhage among extremely preterm infants: a systematic literature review
- Commentary
- Professional integrity in maternal – fetal innovation and research: an essential component of perinatal medicine
- WAPM Recommendations
- WAPM-World Association of Perinatal Medicine Practice Guidelines: Fetal central nervous system examination
- Corner of Academy
- Education in developing countries and reducing maternal mortality: a forgotten piece of the puzzle?
- Original Articles – Obstetrics
- The contemporary value of dedicated preterm birth clinics for high-risk singleton pregnancies: 15-year outcomes from a leading maternal centre
- Chorioamnionitis after premature rupture of membranes in nulliparas undergoing labor induction: prostaglandin E2 vs. oxytocin
- Maternal and fetal outcomes in pregnancies with obstructive sleep apnea
- Assessing the involvement of the placental microbiome and virome in preeclampsia using non coding RNA sequencing
- Risk of metformin failure in the treatment of women with gestational diabetes
- Can we improve our ability to interpret category II fetal heart rate tracings using additional clinical parameters?
- New obstetric systemic inflammatory response syndrome criteria for early identification of high-risk of sepsis in obstetric patients
- Bacteria in the amniotic fluid without inflammation: early colonization vs. contamination
- Intertwin differences in umbilical artery pulsatility index are associated with infant survival in twin-to-twin transfusion syndrome
- Maternal and neonatal outcomes in women with disorders of lipid metabolism
- The use of PAMG-1 testing in patients with preterm labor, intact membranes and a short sonographic cervix reduces the rate of unnecessary antenatal glucocorticoid administration
- Original Articles – Neonates
- The effect of postnatal corticosteroids on growth parameters in infants with bronchopulmonary dysplasia
- Are neonatal outcomes of triplet pregnancies different from those of singletons according to gestational age?
- Impact of paternal presence and parental social-demographic characteristics on birth outcomes
- Letter to the Editor
- Comment on: “amniotic fluid embolism – implementation of international diagnosis criteria and subsequent pregnancy recurrence risk”
