title: Psychological consequences of having triplets: a 4-year follow-up study.
abstract: OBJECTIVE
  To assess the mental health of mothers of triplets and the quality of relationship with the children 4 years after delivery.
  
  
  METHODS
  Prospective follow-up study from delivery, to 4 years. Assessments at home by a psychologist, using semistructured tape-recorded interviews.
  
  
  METHODS
  One maternity hospital in Paris, France.
  
  
  METHODS
  Eleven consecutive mothers having delivered triplets between October 1988 and February 1990. All except one had conceived after infertility treatment.
  
  
  METHODS
  Evaluation of the mothers' emotional well-being and level of depression measured by the CES-D Scale (Center for Epidemiologic Studies-Depression Scale). Opinion of the mothers about the quality of the relationship with the children.
  
  
  RESULTS
  All mothers reported emotional distress at 4 years, mainly fatigue and stress. Four mothers had a high score of depression and used psychotropic medication. The relationship with the children and difficulties in coping with their aggressive behavior and conflicts were the main reason for psychological distress. Difficulties had not decreased since the previous assessment at 2 years. Four mothers spontaneously expressed regrets about having triplets.
  
  
  CONCLUSIONS
  Patients undergoing infertility treatments should receive adequate information about the long-term psychological "cost" of a triplet birth. Infertility treatments should be adapted in order to decrease the risk of triplet pregnancies.
authors.affiliation: Epidemiological Research Unit, Institut National de la Santé et de la Recherche Médicale (INSERM) U 149, Villejuif, France.
authors.forename: M
authors.initials: M
authors.lastname: Garel
authors.forename: C
authors.initials: C
authors.lastname: Salobir
authors.forename: B
authors.initials: B
authors.lastname: Blondel
mesh_terms: D000223:Adaptation, Psychological; D002675:Child, Preschool; D004644:Emotions; D005500:Follow-Up Studies; D006801:Humans; D007407:Interviews as Topic; D008603:Mental Health; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology*; D011446:Prospective Studies; D013315:Stress, Psychological; D014310:Triplets