Zhou Yanzhen, Lin Jinxiu, Liu Zhaozhen, Lin Sheng
Department of Obstetrics and Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, China.
Eur J Obstet Gynecol Reprod Biol X. 2025 May 31;26:100394. doi: 10.1016/j.eurox.2025.100394. eCollection 2025 Jun.
As triplet pregnancies were usually associated with poorer pregnancy outcomes and fetal reduction was coupled with procedure-related complications, many women with triplet pregnancies often opted for expectant management. This retrospective study reported the pregnancy outcomes of women with triplet pregnancies who did not receive artificial fetal reduction over a two-decade period (2002-2021).
Maternal and pregnancy data and perinatal outcomes, including 111 triplets, were obtained from women with triplet pregnancies who received expectant management at Fujian Maternity and Child Health Hospital, including 111 triplets. The patient cohort was divided into two subgroups(Period I, 2002-2011 vs. Period II, 2012-2021).
Compared with those in the Period I group, participants in the Period II group reported a better educational background (28.8 vs. 13.8 %, p = 0.024), and occupation status (40.4 vs. 20.6 %, p = 0.012) and a greater percentage of primiparas (57.7 vs. 5.1 %, p < 0.005). However, compared with those in the Period II group, the period I group displayed significantly older gestation age at delivery(p = 0.001), heavier mean birth weight(1583.63 ± 62.14 vs.1830.51 ± 41.95 kg), higher rate of babies taken home(91.6 vs. 84.2 %,p = 0.049), and lower NICU admission rate(47.0 vs. 77.5 %, p < 0.005).
Due attention to triplet pregnancies might lower the rate of maternity complications, and antenatal medicines to prevent prematurity could not prolong birth week. Developed neonatal treatment and nursing are adapted to stratified management based on chorionicity. With advancements in maternal healthcare and neonatal treatment, and nursing, expectant management could be a considerable option. Maternal factors such as parity and maternal education status might be correlated with gestational age.
由于三胎妊娠通常与较差的妊娠结局相关，且减胎术会带来与手术相关的并发症，许多三胎妊娠女性常选择期待治疗。这项回顾性研究报告了20年期间（2002 - 2021年）未接受人工减胎术的三胎妊娠女性的妊娠结局。
从在福建省妇幼保健院接受期待治疗的三胎妊娠女性中获取包括111例三胞胎的孕产妇及妊娠数据和围产期结局。将患者队列分为两个亚组（第一阶段，2002 - 2011年与第二阶段，2012 - 2021年）。
与第一阶段组相比，第二阶段组参与者的教育背景更好（28.8%对13.8%，p = 0.024）、职业状况更好（40.4%对20.6%，p = 0.012），初产妇比例更高（57.7%对5.1%，p < 0.005）。然而，与第二阶段组相比，第一阶段组分娩时的孕周明显更大（p = 0.001），平均出生体重更重（1583.63±62.14对1830.51±41.95千克），带回家的婴儿比例更高（91.6%对84.2%，p = 0.049），新生儿重症监护病房（NICU）入住率更低（47.0%对77.5%，p < 0.005）。
对三胎妊娠给予应有的关注可能会降低孕产妇并发症的发生率，预防早产的产前药物并不能延长孕周。发达的新生儿治疗和护理应根据绒毛膜性进行分层管理。随着孕产妇医疗保健以及新生儿治疗和护理的进步，期待治疗可能是一个相当不错的选择。诸如产次和孕产妇教育状况等孕产妇因素可能与孕周相关。
