{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T15:06:55Z","timestamp":1788448015769,"version":"build-2803163510"},"reference-count":29,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,12,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVES:<\/jats:title>\n                    <jats:p>To compare the neonatal outcomes of very preterm triplets with those of matched singletons using a large international cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>A total of 6079 triplets of 24 to 32 weeks\u2019 gestation or 500 to 1499 g birth weight and 18\u2009232 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\u20131.01 for model 1 and 1.00, 95% CI: 0.90\u20131.11 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\u2019 gestation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.2018-1938","type":"journal-article","created":{"date-parts":[[2018,11,21]],"date-time":"2018-11-21T03:24:25Z","timestamp":1542770665000},"source":"Crossref","is-referenced-by-count":17,"title":["Neonatal Outcomes of Very Preterm or Very Low Birth Weight Triplets"],"prefix":"10.1542","volume":"142","author":[{"given":"Prakesh S.","family":"Shah","sequence":"first","affiliation":[{"name":"Department of Pediatrics and"},{"name":"Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, Canada;"},{"name":"Departments of Pediatrics and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Kusuda","sequence":"additional","affiliation":[{"name":"National Research Network Japan, Department of Pediatrics, Kyorin University, Mitaka, Japan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stellan","family":"H\u00e5kansson","sequence":"additional","affiliation":[{"name":"Swedish Neonatal Quality Register, Unit of Pediatrics, Department of Clinical Science, Ume\u00e5 University, Ume\u00e5, Sweden;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Reichman","sequence":"additional","affiliation":[{"name":"Israel Neonatal Network, Gertner Institute for Epidemiology and Health Policy Research, Tel Hashomer, Israel;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kei","family":"Lui","sequence":"additional","affiliation":[{"name":"Australian and New Zealand Neonatal Network, Department of Newborn Care, Royal Hospital for Women and School of Women\u2019s and Children\u2019s Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liisa","family":"Lehtonen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Adolescent Medicine, Turku University Hospital and Department of Clinical Medicine, University of Turku, Turku, Finland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neena","family":"Modi","sequence":"additional","affiliation":[{"name":"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;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximo","family":"Vento","sequence":"additional","affiliation":[{"name":"Spanish Neonatal Network, Health Research Institute La Fe, Avenida Fernando Abril Martorell, Valencia, Spain;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Adams","sequence":"additional","affiliation":[{"name":"Swiss Neonatal Network, Department of Neonatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franca","family":"Rusconi","sequence":"additional","affiliation":[{"name":"TIN Toscane Online, Unit of Epidemiology, Meyer Children\u2019s University Hospital, Regional Health Agency, Florence, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikael","family":"Norman","sequence":"additional","affiliation":[{"name":"Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden;"},{"name":"Department of Neonatal Medicine, Karolinska University Hospital, Stockholm, Sweden;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian A.","family":"Darlow","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, University of Otago, Christchurch, Canterbury, New Zealand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhay","family":"Lodha","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junmin","family":"Yang","sequence":"additional","affiliation":[{"name":"Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"Bassler","sequence":"additional","affiliation":[{"name":"Swiss Neonatal Network, Department of Neonatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kjell K.","family":"Helenius","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Adolescent Medicine, Turku University Hospital and Department of Clinical Medicine, University of Turku, Turku, Finland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuya","family":"Isayama","sequence":"additional","affiliation":[{"name":"Division of Neonatology, National Center for Child Health and Development, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoo K.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and"},{"name":"Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, Canada;"},{"name":"Departments of Pediatrics and"},{"name":"Obstetrics and Gynecology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the International Network for Evaluation of Outcomes (iNEO) in Neonates Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2018,12,1]]},"reference":[{"issue":"3","key":"2021121013311158400_B1","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1017\/thg.2015.27","article-title":"Triplet pregnancy: is the mode of conception related to perinatal outcomes?","volume":"18","author":"Fennessy","year":"2015","journal-title":"Twin Res Hum Genet"},{"issue":"3","key":"2021121013311158400_B2","doi-asserted-by":"crossref","first-page":"e0149252","DOI":"10.1371\/journal.pone.0149252","article-title":"Variations in multiple birth rates and impact on perinatal outcomes in Europe.","volume":"11","author":"Heino","year":"2016","journal-title":"PLoS One"},{"issue":"5","key":"2021121013311158400_B3","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1055\/s-2007-994341","article-title":"Changing epidemiology of triplet pregnancy: etiology and outcome over twelve years.","volume":"13","author":"Ho","year":"1996","journal-title":"Am J Perinatol"},{"issue":"4","key":"2021121013311158400_B4","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1055\/s-0031-1285100","article-title":"The changing epidemiology of preterm twins and triplets admitted to neonatal intensive care units in Canada, 2003 to 2008.","volume":"29","author":"Bassil","year":"2012","journal-title":"Am J Perinatol"},{"issue":"243","key":"2021121013311158400_B5","first-page":"1","article-title":"Declines in triplet and higher-order multiple births in the United States, 1998-2014.","author":"Martin","year":"2016","journal-title":"NCHS Data Brief"},{"issue":"1298","key":"2021121013311158400_B6","first-page":"39","article-title":"Infant and perinatal outcomes of triplet pregnancy in Auckland: better than expected?","volume":"122","author":"Battin","year":"2009","journal-title":"N Z Med J"},{"issue":"4","key":"2021121013311158400_B7","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1055\/s-2001-15505","article-title":"Maternal and neonatal outcome of 100 consecutive triplet pregnancies.","volume":"18","author":"Devine","year":"2001","journal-title":"Am J Perinatol"},{"issue":"1","key":"2021121013311158400_B8","doi-asserted-by":"crossref","first-page":"108","DOI":"10.15547\/tjs.2016.01.016","article-title":"Complications of multiple pregnancies. 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