Characteristics, management and outcomes of very preterm triplets in 19 European regions

Autores da FMUP

• Teresa Maria Alves Rodrigues

  Autor

• José Henrique Dias Pinto De Barros

  Autor

Participantes de fora da FMUP

• Dudenhausen, Joachim W.
• Misselwitz, Bjoern
• Piedvache, Aurelie
• Maier, Roif F.
• Weber, Tom
• Zeitlin, Jennifer
• Schmidt, Stephan
• Martens, E.
• Martens, G.
• Van Reempts, P.
• Boerch, K.
• Hasselager, A.
• Huusom, L.
• Pryds, O.
• Weber, T.
• Toome, L.
• Varendi, H.
• Ancel, P. Y.
• Blondel, B.
• Burguet, A.
• Jarreau, P. H.
• Truffert, P.
• Maier, R. F.
• Misselwitz, B.
• Schmidt, S.
• Gortner, L.
• Baronciani, D.
• Gargano, G.
• Agostino, R.
• DiLallo, D.
• Franco, F.
• Camielli, V
• Cuttini, M.
• Koopman-Esseboom, C.
• Van Heijst, A.
• Nijman, J.
• Gadzinowski, J.
• Mazela, J.
• Graca, L. M.
• Achado, M. C.
• Rodrigues, C.
• Bonamy, A. K.
• Norman, M.
• Wilson, E.
• Boyle, E.
• Draper, E. S.
• Manktelow, B. N.
• Fenton, A. C.
• Milligan, D. W. A.
• Zeitlin, J.
• Bonet, M.
• Piedvache, A.
• EPICE Res Grp

Unidades de investigação

• Ciências da Saúde Pública e Forenses, e Educação Médica

Abstract

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.

Keywords

• Cesarean section; Fetal growth restriction; In-hospital mortality; Neonatal morbidity; Stillbirth; Triplets; Very preterm birth