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Pediatrics. 2018 Dec;142(6). pii: e20181938. doi: 10.1542/peds.2018-1938.

Neonatal Outcomes of Very Preterm or Very Low Birth Weight Triplets.

Author information

1
Department of Pediatrics and prakeshkumar.shah@sinaihealthsystem.ca.
2
Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, Canada.
3
Departments of Pediatrics and.
4
National Research Network Japan, Department of Pediatrics, Kyorin University, Mitaka, Japan.
5
Swedish Neonatal Quality Register, Unit of Pediatrics, Department of Clinical Science, Umeå University, Umeå, Sweden.
6
Israel Neonatal Network, Gertner Institute for Epidemiology and Health Policy Research, Tel Hashomer, Israel.
7
Australian and New Zealand Neonatal Network, Department of Newborn Care, Royal Hospital for Women and School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.
8
Department of Pediatrics and Adolescent Medicine, Turku University Hospital and Department of Clinical Medicine, University of Turku, Turku, Finland.
9
United Kingdom Neonatal Collaborative, Neonatal Data Analysis Unit, Section of Neonatal Medicine, Department of Medicine, Imperial College London and Chelsea and Westminster Hospital, London, United Kingdom.
10
Spanish Neonatal Network, Health Research Institute La Fe, Avenida Fernando Abril Martorell, Valencia, Spain.
11
Swiss Neonatal Network, Department of Neonatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
12
TIN Toscane Online, Unit of Epidemiology, Meyer Children's University Hospital, Regional Health Agency, Florence, Italy.
13
Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
14
Department of Neonatal Medicine, Karolinska University Hospital, Stockholm, Sweden.
15
Department of Paediatrics, University of Otago, Christchurch, Canterbury, New Zealand.
16
Departments of Pediatrics and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; and.
17
Division of Neonatology, National Center for Child Health and Development, Tokyo, Japan.
18
Department of Pediatrics and.
19
Obstetrics and Gynecology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.

Abstract

OBJECTIVES:

To compare the neonatal outcomes of very preterm triplets with those of matched singletons using a large international cohort.

METHODS:

A retrospective matched-cohort study of preterm triplets and singletons born between 2007 and 2013 in the International Network for Evaluation of Outcomes in neonates database countries and matched by gestational age, sex, and country of birth was conducted. The primary outcome was a composite of mortality or severe neonatal morbidity (severe neurologic injury, treated retinopathy of prematurity, and bronchopulmonary dysplasia). Unadjusted and adjusted odds ratios with 95% confidence intervals (CIs) were calculated for model 1 (maternal hypertension and birth weight z score) and model 2 (variables in model 1, antenatal steroids, and mode of birth). Models were fitted with generalizing estimating equations and random effects modeling to account for clustering.

RESULTS:

A total of 6079 triplets of 24 to 32 weeks' gestation or 500 to 1499 g birth weight and 18 232 matched singletons were included. There was no difference in the primary outcome between triplets and singletons (23.4% vs 24.0%, adjusted odds ratio: 0.91, 95% CI: 0.83-1.01 for model 1 and 1.00, 95% CI: 0.90-1.11 for model 2). Rates of severe neonatal morbidities did not differ significantly between triplets and singletons. The results were also similar for a subsample of the cohort (1648 triplets and 4944 matched singletons) born at 24 to 28 weeks' gestation.

CONCLUSIONS:

No significant differences were identified in mortality or major neonatal morbidities between triplets who were very low birth weight or very preterm and matched singletons.

PMID:
30463851
DOI:
10.1542/peds.2018-1938

Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

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