Kyeong Kyu-Sang, Shim Jae-Yoon, Oh Soo-Young, Won Hye-Sung, Lee Pil Ryang, Kim Ahm, Yun Sung-Cheol, Kang Pureun-Narae, Choi Suk-Joo, Roh Cheong-Rae
Department of Obstetrics and Gynecology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea.
Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Obstet Gynecol Sci. 2019 Jul;62(4):224-232. doi: 10.5468/ogs.2019.62.4.224. Epub 2019 Jun 17.
This study was conducted to demonstrate the temporal trends in perinatal outcomes of triplet pregnancies over the last two decades.
The medical records of patients with triplet pregnancies at two Korean tertiary-care hospitals from 1992 to 2012 were retrospectively reviewed in regard to maternal and neonatal outcomes. The study was divided into two periods for analysis: period I (1992-2001) and period II (2003-2012).
Over a 21-year period, 65 women with triplet pregnancies and 185 neonates were analyzed. Period II, when compared with period I, was associated with improved maternal outcomes, characterized by a decreased incidence of preeclampsia (31.8% vs. 2.3%, =0.002) and anemia (68.2% vs. 30.2%, =0.003) during pregnancy. Regarding neonatal aspects, the composite morbidity of period II was significantly decreased compared with that of period I, as assessed with a generalized estimating equation for logistic regression (26.2% vs. 8.1%, =0.03). Multivariable analysis revealed that the gestational age at delivery and the period were significantly associated with the composite neonatal morbidity (<0.001 and 0.007, respectively).
Improved neonatal morbidity was associated with a higher gestational age at delivery and with the more recent decade.
本研究旨在阐明过去二十年间三胎妊娠围产期结局的时间趋势。
回顾性分析了1992年至2012年韩国两家三级医疗机构中三胎妊娠患者的病历，涉及母体和新生儿结局。该研究分为两个时期进行分析：第一期（1992 - 2001年）和第二期（2003 - 2012年）。
在21年期间，分析了65例三胎妊娠妇女及185例新生儿。与第一期相比，第二期母体结局有所改善，表现为孕期子痫前期发病率降低（31.8%对2.3%，P = 0.002）和贫血发病率降低（68.2%对30.2%，P = 0.003）。在新生儿方面，采用广义估计方程进行逻辑回归分析显示，第二期的综合发病率较第一期显著降低（26.2%对8.1%，P = 0.03）。多变量分析表明，分娩时的孕周和时期与新生儿综合发病率显著相关（分别为P<0.001和P = 0.007）。
新生儿发病率的改善与分娩时较高的孕周以及更近的十年相关。
