title: Comparison between singleton- and triplet-specific "growth" curves to detect growth restricted triplet infants.
abstract: OBJECTIVE
  To evaluate whether triplet- or singleton-specific growth standards should be used to define the growth restricted triplet fetus/neonate.
  
  
  METHODS
  We retrospectively compared the predictive values of singleton vs. triplet-specific "growth" standards using the neonatal ponderal index as reference for growth restriction.
  
  
  RESULTS
  A ponderal index <1 SD from the mean was found in 356 (14.4%) of 2477 triplet infants. A total of 686 (27.7%) infants were small for gestational age (SGA) by singleton standards, but only 168 (6.8%) by triplet standards. After 31 weeks' gestation, triplet standards are significantly better associated with a low ponderal index (OR 2.0, 95% CI 1.1, 3.4 at 32 weeks to OR 4.1, 95% CI 2.8, 6.3 at 36-37 weeks), resulting in better positive predictive value and higher specificity of triplet standards in predicting a low ponderal index.
  
  
  CONCLUSIONS
  Triplet birth weight standards are better than singleton standards at >31 but not at < or =31 weeks' gestation in predicting a low neonatal ponderal index.
authors.affiliation: Department of Obstetrics and Gynecology, Hadassah-Hebrew University School of Medicine, Jerusalem, Israel.
authors.forename: Mirit
authors.initials: M
authors.lastname: Shoshani
authors.forename: Debbie J
authors.initials: DJ
authors.lastname: Rhea
authors.forename: Louis G
authors.initials: LG
authors.lastname: Keith
authors.forename: Isaac
authors.initials: I
authors.lastname: Blickstein
mesh_terms: D001724:Birth Weight; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D047109:Fetal Development; D005317:Fetal Growth Retardation / Q000175:diagnosis*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D011237:Predictive Value of Tests; D011247:Pregnancy; D014310:Triplets