To examine the development of triplets, 23 sets of triplets were matched with 23 sets of twins and 23 singletons (N=138). Maternal sensitivity was observed at newborn, 3, 6, and 12 months, and infants' cognitive and symbolic skills at 1 year. Triplets received lower maternal sensitivity across infancy and exhibited poorer cognitive competencies compared with singletons and twins. The most medically compromised triplet showed the lowest regulation, received lower maternal sensitivity, and demonstrated the weakest outcomes compared with siblings. Structural modeling charted three levels of influence on cognitive outcomes: direct, indirect, and contextual. The triplet ecology provides a context for assessing the relations among infant inborn dispositions, the rearing environment, and the role of exclusive parenting in development.

Parenting Stress, Infant Emotion Regulation, Maternal Sensitivity, and the Cognitive Development of Triplets: A Model for Parent and Child Influences in a Unique Ecology

1. Introduction 2. Lesbian mother families 3. 'Test-tube' baby families 4. Donor conception families 5. Surrogacy families 6. Solo mother families 7. Gay father families 8. Conclusions.

Modern Families: Parents and Children in New Family Forms

Objective. To examine whether a triplet birth per se poses a risk to the development of infants9 cognitive competencies and to the mother-infant relationship. Methods. Twenty-three sets of triplets were matched with 23 sets of twins and 23 singleton infants (n = 138) with respect to gestational age, birth weight, and medical and demographic features. Infants with perinatal asphyxia, intraventricular hemorrhage of grade 3 or 4, periventricular leukomalacia, or central nervous system infection were excluded from the study. At 6, 12, and 24 months of age, mother-infant interaction was observed and infants9 cognitive development was tested with the Bayley II test. Results. Mothers of triplets displayed lower levels of sensitivity at 6, 12, and 24 months and infants were less socially involved at 6 and 24 months, compared with singletons and twins. Triplets scored lower than singletons and twins on the Bayley Mental Developmental Index at 6, 12, and 24 months. A weight discordance of >15% was found for 15 triplet sets (65.2%). The discordant triplets showed decreased cognitive skills at 12 and 24 months, compared with their siblings, and received the lowest scores for maternal sensitivity. Hierarchical multivariate regression analysis revealed that greater medical risk at birth, multiple-birth status, lower maternal sensitivity, and reduced infant social involvement in the first 2 years were each predictive of lower cognitive outcomes at 2 years (R2 = 0.33). Conclusions. Triplets appear to be at higher risk for cognitive delays in the first 2 years of life, and discordant infants are at especially high risk. This delay is related in part to the difficulty of providing sensitive mothering to 3 infants at the same time. The findings may assist practitioners in guiding prenatal and postpartum parental care and management.

Does a triplet birth pose a special risk for infant development? Assessing cognitive development in relation to intrauterine growth and mother-infant interaction across the first 2 years

Journal de Gynecologie Obstetrique et Biologie de la Reproduction - Vol. 31 - N° 8 - p. 725-740

The increase in multiple births and its consequences on perinatal health

BACKGROUND: The aim of the study was to examine the quality of parenting and the psychological development of three-year-old children in IVF/ICSI families with triplets. METHODS: Comparisons were carried out between a representative sample of 10 families with triplets and matched groups of 15 families with twins and 30 families with singletons. The families were recruited from Follow-Up, a national organization in France that was established to study children conceived by assisted reproduction. Standardized measures of the mother’s psychological well-being (parenting stress, depression and quality of marriage) and standardized measures of the child’s psychological development (emotional/behavioural problems and general development) were completed by the mother. RESULTS: Mothers with a multiple birth were found to experience greater difficulties in parenting than mothers of singletons, with no differences between mothers of triplets and mothers of twins. Regarding the children, there were no differences in emotional or behavioural problems between triplets, twins and singletons. However, there were indications of mild delay among triplets and twins in some aspects of language development in comparison with the singleton children. CONCLUSIONS: The birth of triplets or twins does appear to cause difficulties for parents in the early years, however, the children themselves do not seem to experience markedly raised levels of psychological or developmental problems.

Parenting and the psychological development of a representative sample of triplets conceived by assisted reproduction.

Resume Objectifs – Etudier la sante psychique et les difficultes des meres sept ans apres la naissance de triples et comparer ces resultats avec ceux observes trois ans plus tot. Donnees et methode – Onze meres de triples ont ete suivies de la naissance a sept ans. A quatre et sept ans l’etat psychologique des meres et les relations avec les enfants ont ete apprecies par un entretien semi-directif et la depression a ete evaluee a l’aide d’une echelle standardisee (CES-D). A sept ans les scores ont ete compares a ceux d’un groupe de meres ayant un enfant « singleton » du meme âge. Resultats – A sept ans trois meres de triples sur 11 souffrent toujours de symptomes depressifs. Cette frequence est plus importante que chez les meres temoins mais de facon non significative. Une mere de triples sur deux (six sur 11), deux fois plus qu’a quatre ans, apprecie son role d’educatrice et la diminution des tâches materielles. Dans l’autre moitie de l’echantillon, les problemes persistent entre adultes et enfants. Conclusion – Bien que la situation semble s’ameliorer a sept ans, la souffrance psychologique des meres et la qualite de leurs relations avec les enfants restent preoccupantes dans une famille sur deux.

Les mères de triplés et leurs enfants : évolution de quatre à sept ans après la naissance

UNLABELLED: The aim of this study was to assess the development and behaviour of 7-y-old triplets, who were followed from delivery to 7 y of age. The McCarthy Scales of Children's Abilities (MSCA) and Achenbach's Child Behaviour Checklist (CBCL) were used to assess and compare development and behaviour in the triplets and in a control group of singletons. The sample included 33 sets of triplets and 33 singletons, all 7-y-olds, and comparable for sex and fathers' social class. The triplets' scores on the MSCA were all within normal range. Although their mean scores for all subtests were below those of singletons, they did not differ significantly. The mean CBCL scores, based on mothers' reports, indicated that the triplets had significantly fewer behavioural problems than the controls. In half the triplet sets, one child stood out as having more behavioural problems than the others. CONCLUSION: Further assessments of the development of triplets are needed; these should be based on larger study samples and should use information from teachers and external observers as well as mothers.

C Salobir

Papers

Les mères de triplés et leurs enfants : évolution de quatre à sept ans après la naissance

Development and behaviour of seven-year-old triplets.

[Psychological consequences of triplet births: evaluation at four years].