{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T08:07:21Z","timestamp":1789891641755,"version":"4.0.1"},"reference-count":23,"publisher":"Georg Thieme Verlag KG","issue":"S 01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objective\u2003The aim of the study is to describe the maternal health burden and perinatal outcomes in triplet pregnancies, and identify the maternal and pregnancy indicators associated with increased perinatal morbidity and mortality.<\/jats:p><jats:p>\n          Study Design\u2003This is a retrospective cohort study of triplet pregnancies from 2007 to 2014. Maternal data were manually collected and assessed until 6 weeks postpartum, and neonatal data were assessed until hospital discharge or death.<\/jats:p><jats:p>\n          Results\u2003Eighty-two triplet pregnancies were identified with 246 babies born. Mean gestational age at delivery was 32.3 (standard deviation [SD]\u2009\u00b1\u20093.6) weeks and average birth weight was 1,726\u2009g (SD\u2009\u00b1\u2009500). There were 12 perinatal deaths and 25 (10.2%) infants diagnosed with a congenital anomaly. Prior preterm birth and nulliparity had a negative impact on gestational age at delivery (p\u2009=\u20090.016) as compared with prior full-term births. Pregnancy complications (preeclampsia or hypertensive disorders [46.3%], gestational diabetes [28%], postpartum hemorrhage [9.8%], and blood transfusions [8.5%]) also impacted gestational age at delivery (33.0 vs. 34.0 weeks, p\u2009=\u20090.031). Spontaneous conception, chorionicity, and maternal medical problems did not have an impact on median gestational age.<\/jats:p><jats:p>\n          Conclusion\u2003Nulliparity and presence of pregnancy complications are pertinent to triplet outcomes. This study provides valuable information for anticipatory guidance and preconception counseling to patients considering artificial reproductive technology.<\/jats:p>","DOI":"10.1055\/s-0040-1709489","type":"journal-article","created":{"date-parts":[[2020,4,24]],"date-time":"2020-04-24T23:36:44Z","timestamp":1587771404000},"page":"e256-e261","source":"Crossref","is-referenced-by-count":9,"special_numbering":"S","title":["The Maternal Impact, Health Burden, and Postpartum Sequela in Triplet Pregnancies: A Retrospective Cohort"],"prefix":"10.1055","volume":"38","author":[{"given":"Donna S.","family":"Lambers","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, TriHealth, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Allen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, TriHealth, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Gottula","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, TriHealth, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6595-3975","authenticated-orcid":false,"given":"C. Ganga","family":"Devaiah","sequence":"additional","affiliation":[{"name":"Hatton Research Institute, TriHealth, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mounira","family":"Habli","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, TriHealth, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2020,4,24]]},"reference":[{"issue":"10","key":"ref1","doi-asserted-by":"crossref","first-page":"794","DOI":"10.2471\/BLT.13.117564","article-title":"Measuring maternal health: focus on maternal morbidity","volume":"91","author":"T Firoz","year":"2013","journal-title":"Bull World Health Organ"},{"issue":"05","key":"ref2","doi-asserted-by":"crossref","first-page":"1118","DOI":"10.1097\/01.AOG.0000446856.51061.3e","article-title":"ACOG Practice Bulletin No. 144: multifetal gestations: twin, triplet, and higher-order multifetal pregnancies","volume":"123","year":"2014","journal-title":"Obstet Gynecol"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"B2","DOI":"10.1016\/j.ajog.2019.04.013","article-title":"SMFM special statement: state of the science on multifetal gestations: unique considerations and importance","volume":"221","author":"K L Grantz","year":"2019","journal-title":"Am J Obstet Gynecol"},{"issue":"287","key":"ref4","first-page":"1","article-title":"Births in the United States, 2016","author":"J A Martin","year":"2017","journal-title":"NCHS Data Brief"},{"issue":"243","key":"ref5","first-page":"1","article-title":"Declines in triplet and higher-order multiple births in the United States, 1998-2014","author":"J A Martin","year":"2016","journal-title":"NCHS Data Brief"},{"issue":"05","key":"ref6","doi-asserted-by":"crossref","first-page":"1551","DOI":"10.1016\/S0002-9378(96)70605-1","article-title":"The maternal and neonatal outcome of triplet gestations","volume":"174","author":"J L Albrecht","year":"1996","journal-title":"Am J Obstet Gynecol"},{"issue":"04","key":"ref7","doi-asserted-by":"crossref","first-page":"1463","DOI":"10.1016\/j.ajog.2005.02.098","article-title":"Perinatal outcome of spontaneously conceived triplet pregnancies in relation to chorionicity","volume":"193","author":"A L Adegbite","year":"2005","journal-title":"Am J Obstet Gynecol"},{"issue":"04","key":"ref8","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1007\/s00404-013-2796-x","article-title":"Maternal and neonatal outcome in triplet, quadruplet and quintuplet gestations following ART: a 11-year study","volume":"288","author":"R Chibber","year":"2013","journal-title":"Arch Gynecol Obstet"},{"issue":"05","key":"ref9","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1038\/sj.jp.7210950","article-title":"Triplet morbidity and mortality in a large case series","volume":"23","author":"S Barr","year":"2003","journal-title":"J Perinatol"},{"issue":"03","key":"ref10","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1007\/s00404-015-3995-4","article-title":"Prediction of perinatal mortality in triplet pregnancies","volume":"294","author":"C B Maia","year":"2016","journal-title":"Arch Gynecol Obstet"},{"issue":"03","key":"ref11","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1007\/s13224-017-1002-7","article-title":"Maternal and early perinatal outcomes of triplet pregnancy: study of 82 triplets from a single perinatal centre in South India","volume":"68","author":"P Rajan","year":"2018","journal-title":"J Obstet Gynaecol India"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1097\/00006250-200006000-00022","article-title":"Maternal morbidity and mortality associated with multiple gestations","volume":"95","author":"A Conde-Agudelo","year":"2000","journal-title":"Obstet Gynecol"},{"issue":"02","key":"ref13","doi-asserted-by":"crossref","first-page":"e214","DOI":"10.1542\/peds.2009-0913","article-title":"New intrauterine growth curves based on United States data","volume":"125","author":"I E Olsen","year":"2010","journal-title":"Pediatrics"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"d5714","DOI":"10.1136\/bmj.d5714","article-title":"Antenatal care for twin and triplet pregnancies: summary of NICE guidance","volume":"343","author":"C Visintin","year":"2011","journal-title":"BMJ"},{"issue":"01","key":"ref15","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.ijgo.2012.10.022","article-title":"Clinical features and short-term outcomes of triplet pregnancies in Japan","volume":"121","author":"M Morikawa","year":"2013","journal-title":"Int J Gynaecol Obstet"},{"issue":"02","key":"ref16","doi-asserted-by":"crossref","first-page":"147.e1","DOI":"10.1016\/j.ajog.2014.03.017","article-title":"Can differences in obstetric outcomes be explained by differences in the care provided? 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