Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
Division of Obstetrics, Department of Women's Health, Karolinska University Hospital, Stockholm, Sweden.
Ups J Med Sci. 2023 Jul 17;128. doi: 10.48101/ujms.v128.9473. eCollection 2023.
Triplet pregnancies carry a high risk of pregnancy-related complications. The primary aim of this study was to describe maternal, pregnancy, and neonatal outcomes in expectantly managed triplet pregnancies in Sweden. The secondary aim was to compare outcomes in expectantly managed triplet pregnancies with triplet pregnancies where fetal reduction had been performed with the only indication to reduce the number of fetuses.
Nationwide cohort study based on linkage of data from three national Swedish registers. Triplet pregnancies with delivery at gestational age ≥ 22 weeks between 2014 and 2019 were included.
In the main cohort of expectantly managed triplet pregnancies ( = 106), 98% (312/318) of infants were liveborn with a mean gestational age at birth of 32 weeks and a mean birthweight of 1,726 g. Nine percent ( = 29) suffered from severe neonatal morbidity, and 4% ( = 12) died during the neonatal period. In the reduced cohort ( = 13 pregnancies), all infants were liveborn ( = 22). Mean gestational age at birth (36 weeks) and mean birthweight (2,444 g) were higher than in the expectantly managed cohort ( < 0.01 for both comparisons). There were no cases of severe neonatal morbidity ( = 0.24) or mortality ( = 1.00).
Overall neonatal survival from 22 weeks of gestation in expectantly managed triplet pregnancies in Sweden was high. Nine out of 10 infants did not suffer from severe neonatal morbidity. Fetal reduction was performed in only a very small number of cases and was associated with higher gestational age at birth and higher birth weight.
三胞胎妊娠与妊娠相关并发症的风险较高。本研究的主要目的是描述瑞典期待管理的三胞胎妊娠的产妇、妊娠和新生儿结局。次要目的是比较期待管理的三胞胎妊娠与仅以减少胎儿数量为指征进行胎儿减灭的三胞胎妊娠的结局。
基于三个瑞典国家登记处的数据链接进行的全国性队列研究。纳入 2014 年至 2019 年 22 周以上分娩的期待管理三胞胎妊娠。
在期待管理的三胞胎妊娠的主要队列中（n=106），98%（312/318）的婴儿为活产，出生时的平均孕周为 32 周，平均出生体重为 1726g。9%（=29）患有严重新生儿并发症，4%（=12）在新生儿期死亡。在减胎组（n=13 例妊娠）中，所有婴儿均为活产（n=22）。出生时的平均孕周（36 周）和平均出生体重（2444g）均高于期待管理组（均<0.01）。无严重新生儿并发症（n=0.24）或死亡（n=1.00）病例。
瑞典期待管理的三胞胎妊娠中，22 周后新生儿总体存活率较高。90%的婴儿没有发生严重的新生儿并发症。仅在极少数情况下进行胎儿减灭术，且与较高的出生孕周和较高的出生体重相关。
