Bernal Claverol Mireia, Aracil Moreno Irene, Ruiz Minaya María, Fernández Muñoz María, Reyes Angullo Zurine Raquel, González Navarro Pablo, García-Honduvilla Natalio, Ortega Miguel A, García Tizón Santiago, Pintado-Recarte María P, de León-Luis Juan A
Department of Public and Maternal and Child Health, School of Medicine, Complutense University of Madrid, 28040 Madrid, Spain.
Department of Obstetrics and Gynecology, University Hospital Gregorio Marañón, 28009 Madrid, Spain.
J Clin Med. 2024 Mar 20;13(6):1793. doi: 10.3390/jcm13061793.
: The goal of this study was to evaluate the effect of chorionicity on maternal, fetal and neonatal morbidity and mortality in triplet pregnancies in our environment. : A retrospective observational study was carried out on triplet pregnancies that were delivered in a tertiary center between 2006 and 2020. A total of 76 pregnant women, 228 fetuses and 226 live newborns were analyzed. Of these triplet pregnancies, half were non-trichorionic. We analyzed maternal characteristics and obstetric, fetal, perinatal and neonatal complications based on their chorionicity, comparing trichorionic vs. non-trichorionic triplet pregnancies. Prematurity was defined as <34 weeks. We measured perinatal and neonatal mortality, composite neonatal morbidity and composite maternal morbidity. : Newborns with a monochorionic component had a lower gestational age at birth, presented greater prematurity under 34 weeks, lower birth weight, greater probability of birth weight under 2000 g and an APGAR score below 7 at 5 min after birth, more respiratory distress syndrome and, overall, higher composite neonatal morbidity. The monochorionic component of triple pregnancies may entail the development of complications intrinsic to shared circulation and require premature elective termination. This greater prematurity is also associated with a lower birth weight and to the main neonatal complications observed. These findings are in line with those that were previously published in the meta-analysis by our research group and previous literature. : Triplet gestations with a monochorionic component present a higher risk of obstetric, fetal and neonatal morbidity and mortality.
本研究的目的是评估在我们所处环境中三胎妊娠时绒毛膜性对母体、胎儿及新生儿发病率和死亡率的影响。
对2006年至2020年在一家三级中心分娩的三胎妊娠进行了一项回顾性观察研究。共分析了76名孕妇、228名胎儿和226名活产新生儿。在这些三胎妊娠中，一半为非三绒毛膜性。我们根据绒毛膜性分析了母体特征以及产科、胎儿、围产期和新生儿并发症，比较了三绒毛膜性与非三绒毛膜性三胎妊娠。早产定义为孕周<34周。我们测量了围产期和新生儿死亡率、综合新生儿发病率和综合母体发病率。
具有单绒毛膜成分的新生儿出生时孕周较小，34周以下早产情况更严重，出生体重较低，出生体重低于2000g的可能性更大，出生后5分钟时阿氏评分低于7分，呼吸窘迫综合征更多，总体而言，综合新生儿发病率更高。三胎妊娠的单绒毛膜成分可能会引发共享循环所固有的并发症，并需要提前选择性终止妊娠。这种更高的早产率还与较低的出生体重以及观察到的主要新生儿并发症有关。这些发现与我们研究小组之前发表的荟萃分析以及先前文献中的结果一致。
具有单绒毛膜成分的三胎妊娠出现产科、胎儿及新生儿发病率和死亡率的风险更高。
