Triplet pregnancy: changes in morbidity and mortality

Area of Science:

• Neonatalogy
• Perinatology
• Maternal-Fetal Medicine

Background:

• Triplet births present unique challenges in neonatal care.
• Historical data indicates significant declines in triplet perinatal mortality over decades.
• Prematurity remains a key factor in neonatal morbidity, though less so for mortality.

Purpose of the Study:

• To analyze the immediate neonatal morbidity in triplet infants.
• To review trends in triplet morbidity and mortality in the US and Europe.
• To identify optimal care strategies for triplet gestations.

Main Methods:

• Retrospective analysis of 13 sets of triplet infants (39 infants) born between 1981-1988.
• Review of published literature on triplet morbidity and mortality.
• Comparison of current findings with historical data.

Main Results:

• No perinatal deaths occurred in the studied triplet cohort.
• 80% of triplet infants experienced some form of neonatal morbidity.
• Common morbidities included hyperbilirubinemia (51.3%), hypoglycemia (30.8%), and respiratory distress syndrome (28.2%).
• All morbidities were observed in infants with low birth weight (<2000g) and preterm gestation (<35 weeks).
• Triplet perinatal mortality has declined to below 10% over 80 years.

Conclusions:

• Neonatal morbidity is prevalent in triplet infants, particularly those born preterm or with low birth weight.
• Improvements in neonatal resuscitation, care, and cesarean delivery have reduced triplet mortality.
• Optimal care involves antenatal and neonatal services at tertiary centers and planned cesarean delivery.