Neonatal outcome of triplet versus twin and singleton pregnancies: a matched case control study.
OBJECTIVE
To determine the neonatal outcome of triplet gestations versus that of singletons and twins matched for gestational age.


METHODS
All live born triplet gestations delivered between 1 April 1993 and 31 March 2000 were compared to an age matched control group consisting of live born twins and singletons. The neonatal outcome of 116 sets of triplets was compared to that of 116 sets of twins and 116 singletons.


RESULTS
During a 7-year period 116 sets of triplet pregnancies were reviewed. Of 116 sets of live born triplets (348 newborns), 70.67% triplets were born between 33- and 36-week gestation, 28.44% between 28 and 32 weeks and 0.86% less than 28 weeks. Triplets were smaller in weight than singletons but not twins. Apgar score, use of prenatal steroid and sex ratio were similar in the three groups. Incidence of respiratory distress syndrome (RDS), use of surfactant, infants requiring intubation, pneumothorax, patent ductus arteriosus, sepsis, intraventricular hemorrhage, periventricular leucomalacia, retinopathy of prematurity, necrotizing enterocolitis, gastroesophageal reflux and jaundice requiring phototherapy were not statistically different among the three groups. Incidence of major and minor congenital anomalies, percent neonatal intensive care unit (NICU) admissions, and mean duration of NICU stay were also similar. There was no influence of birth order on neonatal outcome of triplet pregnancy and outcome did not significantly change over 7 years of the study period.


CONCLUSIONS
Triplets have a similar outcome to twins and singletons when matched for gestational age. Since outcome is dependent on gestational age, the closer the gestational age is to term the better is the outcome.
Ballabh
Praveen
P
Division of Neonatology, New York Presbyterian Hospital, Weill Medical College of Cornell University, New York, NY 10021, USA. pballabh@msn.com
Kumari
Jaishree
J
AlKouatly
Huda B
HB
Yih
Melissa
M
Arevalo
Ronald
R
Rosenwaks
Zev
Z
Krauss
Alfred N
AN
D000328:Adult; D001997:Bronchopulmonary Dysplasia / Q000453:epidemiology; D016022:Case-Control Studies; D002543:Cerebral Hemorrhage / Q000453:epidemiology; D004374:Ductus Arteriosus, Patent / Q000453:epidemiology; D005260:Female; D005865:Gestational Age; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D007902:Length of Stay; D007969:Leukomalacia, Periventricular / Q000453:epidemiology; D008297:Male; D008423:Maternal Age; D011247:Pregnancy; D011256:Pregnancy Outcome; D011663:Pulmonary Surfactants / Q000008:administration & dosage; D012127:Respiratory Distress Syndrome, Newborn / Q000453:epidemiology; D014310:Triplets; D014427:Twins
D011663:Pulmonary Surfactants