title: Infant and perinatal outcomes of triplet pregnancy in Auckland: better than expected?
abstract: OBJECTIVE
  There were two aims to the study: (1) to provide local outcome data that would be useful in counselling prospective parents of triplets; and (2) to address the deficit in accurate contemporary data on neurodevelopmental outcome and neonatal morbidity for those infants weighing less than 1500 g at birth.
  
  
  METHODS
  We reviewed the outcome of triplet pregnancies born at National Women's Hospital / Auckland City Hospital (Auckland, New Zealand) for 1995-2005 inclusive. For this study triplet pregnancy was defined as a pregnancy beyond 20 weeks leading to registration of at least one birth.
  
  
  RESULTS
  For the study period, 55 triplet pregnancies were identified. Forty-five percent of the pregnancies were reported as spontaneously conceived and 60% had no major complications other than premature delivery. One pregnancy spontaneously aborted; three fetuses from one pregnancy were stillborn, and four infants died in delivery suite. The median gestational age at birth was 32 (23-37) weeks and birth weight 1620 (530-2780) g. The median (range) Apgar score, for liveborns, was 8 (2-10) and 10 (4-10) for 1 and 5 minutes respectively. There were five neonatal deaths. Fifty-three infants, <1500g at birth, underwent formal developmental assessment. Three had cerebral palsy (2 hemiplegia and 1 spastic diplegia); one had marked motor delay and one hearing impairment requiring aids. The median Bayley II MDI was 95 (71-105) and PDI 94 (65-110). Outcomes were categorised in surviving triplets <1500 g as normal in 66%, mild abnormality in 17%, moderate abnormality in 15% and severely abnormal in only 2%.
  
  
  CONCLUSIONS
  Although triplets represent a significant burden on the regional NICUs the outcome, including those <1500 g at birth, compares favourably with that reported.
authors.affiliation: Newborn Services, National Women's Health, Auckland City Hospital, Private Bag 92024, Auckland, New Zealand. malcolmb@adhb.govt.nz
authors.forename: Malcolm
authors.initials: M
authors.lastname: Battin
authors.forename: Michelle
authors.initials: M
authors.lastname: Wise
authors.forename: Anne
authors.initials: A
authors.lastname: DeZoete
authors.forename: Peter
authors.initials: P
authors.lastname: Stone
mesh_terms: D000328:Adult; D002657:Child Development; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000453:epidemiology*; D019102:Infant, Very Low Birth Weight; D008428:Maternal Mortality; D009520:New Zealand; D054238:Perinatal Mortality; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple; D012189:Retrospective Studies; D014310:Triplets; D055815:Young Adult