Review ArticleTemporal changes in rates of stillbirth, neonatal and infant mortality among triplet gestations in the United States
Section snippets
Data source
Data on triplet live births, stillbirths and neonatal and infant mortality were obtained from the National Centers for Health Statistics (NCHS) linked birth/infant death files collected from 1990 to 2002.15 The NCHS links infant deaths (within the first year) to corresponding live births using data provided by individual states and the District of Columbia under the Vital Statistics Cooperative Program. The linked data files contain information on stillbirth, neonatal and infant mortality.
Results
There were a total of 73,186 triplet stillbirths and live births in the United States between 1990 and 2002. We sequentially excluded fetuses with missing data on gestational age (n = 1124), those that were delivered at <22 weeks' gestation, and fetuses that weighed <500 g (n = 5076). These exclusions left us with 66,986 triplet births for analysis. Of these stillbirths and live births, 5724 births occurred during the period of 1990 to 1991 and 13,837 births during the period of 2001 to 2002.
Comment
The present study shows the striking increase in triplet births in the United States. Concurrently, rates of triplet births at <34 weeks have significantly increased over the last decade. During the same period, overall rates of stillbirth and neonatal and infant mortality have decreased.
Our findings of overall decreasing rates in crude stillbirths and infant mortality among triplet births concur with those reported among US twin births.10, 13 They, however, differ from those reported by Joseph
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Cited by (14)
Current practices in the prediction and prevention of preterm birth in patients with higher-order multiple gestations
2015, American Journal of Obstetrics and GynecologyPerinatal death of triplet pregnancies by chorionicity
2013, American Journal of Obstetrics and GynecologyCitation Excerpt :Nevertheless, a lower prevalence of FFTS in DT triplet pregnancies than in monochorionic twin pregnancies could also be related to the outcome. The overall mortality rate at >22 weeks of gestation of all triplet pregnancies in this study, regardless of chorionicity, appears to be relatively low compared with previous reports.15-17,21,22 The lower incidence of ELBW infants in this study than in previous reports15,17 might have been associated with improved management.
Clinical features and short-term outcomes of triplet pregnancies in Japan
2013, International Journal of Gynecology and ObstetricsCitation Excerpt :In addition, the neonates in other studies were born at different periods: 1986–2000 [3,14], 1989–2001 [10], 1995–1997 [12], 1996–2002 [13], and 2001–2002 [11]. According to Getahun et al. [11], perinatal mortality decreased from 60 deaths per 1000 deliveries in 1990–1991 to 38 deaths in 2001–2002 in the USA. We speculate that the lower rate observed in the present study may be due partly to differences in the definition of perinatal mortality and partly to the more recent study period as compared with previous studies.
Epidemiology of Late Preterm (Near-Term) Births
2006, Clinics in PerinatologyCitation Excerpt :Because national data on their trend and prevalence are not available, however, their contribution to the recent increase in the preterm birth rate remains to be quantified. Several investigators have proposed that the declining US stillbirth rates and increasing US preterm births are causally related [28,32–37]. Some have shown that an increase in cesarean deliveries and labor inductions have contributed to reductions in stillbirth among singletons [33] and twins [34], but not among triplets [35].
Characteristics, management and outcomes of very preterm triplets in 19 European regions
2019, International Journal of Gynecology and ObstetricsIncidences of Feto-Fetal Transfusion Syndrome and Perinatal Outcomes in Triplet Gestations with Monochorionic Placentation
2016, Fetal Diagnosis and Therapy
Drs Getahun and Ananth are partially supported through a grant (R01-HD038902) from the National Institutes of Health awarded to Dr Ananth. Dr Amre is supported by a salary award from the Fonds de la recherché en Santé Quebéc.
Reprints not available from the authors. Address correspondence to Darios Getahun, MD, MPH, Division of Epidemiology and Biostatistics, Department of Obstetrics, Gynecology, and Reproductive Sciences, UMDNJ-Robert Wood Johnson Medical School, 125 Paterson Street, New Brunswick, NJ 08901-1977.