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Characteristics, management and outcomes of very preterm triplets in 19 European regions
Author(s) -
Dudenhausen Joachim W.,
Misselwitz Björn,
Piedvache Aurelie,
Maier Rolf F.,
Weber Tom,
Zeitlin Jennifer,
Schmidt Stephan
Publication year - 2019
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12939
Subject(s) - medicine , obstetrics , apgar score , pregnancy , gestation , population , cohort study , prospective cohort study , multiple birth , cohort , pediatrics , gestational age , surgery , environmental health , pathology , biology , genetics
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.