Department of Obstetrics and Gynecology, TriHealth, Cincinnati, Ohio.
Hatton Research Institute, TriHealth, Cincinnati, Ohio.
Am J Perinatol. 2021 Aug;38(S 01):e256-e261. doi: 10.1055/s-0040-1709489. Epub 2020 Apr 24.
The 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.
This 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.
Eighty-two triplet pregnancies were identified with 246 babies born. Mean gestational age at delivery was 32.3 (standard deviation [SD] ± 3.6) weeks and average birth weight was 1,726 g (SD ± 500). 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 ( = 0.016) 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, = 0.031). Spontaneous conception, chorionicity, and maternal medical problems did not have an impact on median gestational age.
Nulliparity 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.
本研究旨在描述三胎妊娠的孕产妇健康负担和围产结局，并确定与围产发病率和死亡率增加相关的孕产妇和妊娠指标。
这是一项 2007 年至 2014 年三胎妊娠的回顾性队列研究。手动收集和评估孕产妇数据，直至产后 6 周，新生儿数据评估直至出院或死亡。
确定了 82 例三胎妊娠，共分娩 246 例婴儿。平均分娩孕周为 32.3（标准差[SD]±3.6）周，平均出生体重为 1726 克（SD±500 克）。有 12 例围产儿死亡，25 例（10.2%）婴儿被诊断为先天性异常。与既往足月产相比，既往早产和不孕对分娩孕周有负面影响（ = 0.016）。妊娠并发症（子痫前期或高血压疾病[46.3%]、妊娠期糖尿病[28%]、产后出血[9.8%]和输血[8.5%]）也影响分娩孕周（33.0 与 34.0 周， = 0.031）。自然受孕、绒毛膜性和母体医学问题对中位妊娠周数没有影响。
不孕和妊娠并发症的存在与三胎妊娠结局相关。本研究为考虑人工生殖技术的患者提供了有价值的信息，以进行预期指导和孕前咨询。
