{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:46:11Z","timestamp":1771548371020,"version":"3.50.1"},"reference-count":20,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,9,15]],"date-time":"2019-09-15T00:00:00Z","timestamp":1568505600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004047","name":"Karolinska Institutet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004047","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To describe obstetrical care and in\u2010hospital outcomes in very preterm triplet pregnancies in a European multiregional cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data from a prospective population\u2010based study of very preterm births between 22\u00a0+\u00a00 and 31\u00a0+\u00a06\u00a0weeks of gestation in 19 regions from 11 European countries participating in the <jats:styled-content style=\"fixed-case\">EPICE<\/jats:styled-content> project in 2011\/2012 were used to describe triplet pregnancies and compare them with twins and singletons.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>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\u2010hospital 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\u2010born triplets were delivered by cesarean. Vaginal delivery was associated with an Apgar score of less than 7, but not with in\u2010hospital mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>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\u2010hospital mortality after live birth was similar to singletons and twins.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.12939","type":"journal-article","created":{"date-parts":[[2019,8,12]],"date-time":"2019-08-12T05:34:15Z","timestamp":1565588055000},"page":"397-403","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Characteristics, management and outcomes of very preterm triplets in 19 European regions"],"prefix":"10.1002","volume":"147","author":[{"given":"Joachim W.","family":"Dudenhausen","sequence":"first","affiliation":[{"name":"Department of Obstetrics Charit\u00e9 \u2013 University Medicine Berlin  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bj\u00f6rn","family":"Misselwitz","sequence":"additional","affiliation":[{"name":"Institute of Quality Assurance Hesse  Eschborn Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aurelie","family":"Piedvache","sequence":"additional","affiliation":[{"name":"INSERM U1153 Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOP\u00e9)  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rolf F.","family":"Maier","sequence":"additional","affiliation":[{"name":"Children\u2032s Hospital Philipps University Marburg  Marburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tom","family":"Weber","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Hvidovre University Hospital  Hvidovre Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Zeitlin","sequence":"additional","affiliation":[{"name":"INSERM U1153 Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOP\u00e9)  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephan","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Obstetrics University Hospital Philipps University  Marburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"the EPICE Research Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,9,15]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.14273"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0149252"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001709"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dep430"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2013-303737"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2003-43420"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2013.05.008"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2016-1990"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i2976"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.13899"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2006.01.043"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2007.10.785"},{"key":"e_1_2_9_14_1","unstructured":"De GeyterC Calhaz\u2010JorgeC KupkaMS et\u00a0al.ART in Europe 2014: results generated from European registries by ESHRE: The European IVF\u2010monitoring Consortium (EIM) for the European Society of Human Reproduction and Embryology (ESHRE). 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