How much have the perinatal outcomes of triplet pregnancies improved over the last two decades?

Abstract

Objective This study was conducted to demonstrate the temporal trends in perinatal outcomes of triplet pregnancies over the last two decades. Methods 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). Results 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%, P =0.002) and anemia (68.2% vs. 30.2%, P =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%, P =0.03). Multivariable analysis revealed that the gestational age at delivery and the period were significantly associated with the composite neonatal morbidity ( P <0.001 and 0.007, respectively). Conclusion Improved neonatal morbidity was associated with a higher gestational age at delivery and with the more recent decade.

Maternal, Perinatal and Neonatal Outcomes of Triplet Pregnancies According to Chorionicity: Our 15-Year Experience in a Tertiary-Level Center

“…In our setting, Revello published a study in 2019 describing the prevalence of maternal and obstetric complications in triplet pregnancies from their experience in another tertiary hospital in our city, where the most frequently observed obstetric complication in triplet pregnancies overall is the threat of preterm labor (56%), premature rupture of membranes (28.9%) and preeclampsia (20.4%) [ 18 ]. Similar findings regarding premature labor and pregnancy-induced hypertensive states have been described in studies of other countries and settings [ 12 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ].…”

Maternal, Perinatal and Neonatal Outcomes of Triplet Pregnancies According to Chorionicity: A Systematic Review of the Literature and Meta-Analysis

“…Two of the articles from the review specifically excluded pregnancies complicated by TTTS; thus, this percentage could be slightly underestimated [ 27 , 28 ]. Fetal malformations were diagnosed in 6.54% of pregnancies, although this was also an exclusion criterion for six of the included studies [ 25 , 28 , 29 , 30 , 31 , 32 ].…”

“…Both our systematic review and meta-analysis collected data on a wide range of outcome measures from a large population sample. This systematic review brings together a large population sample from a large number of studies (46 studies with a total of 43,653 triplet pregnancies and 128,145 live births), collecting information on 47 variables [ 14 , 16 , 21 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 ]. Similarly, this meta-analysis included many articles with a large total population sample (12 studies, 2188 pregnant women, 5790 fetuses, and 5441 live newborns), collecting up to 18 variables [ 14 , 16 , 21 , 24 , 26 ,…”

“…Other neonatal complications resulting from the increased prematurity in triplet pregnancies, are sepsis (5.48%), severe intraventricular hemorrhage (4.6%), retinopathy of the premature (4.12%) and necrotizing enterocolitis (1.67%). [ 14 , 24 , 28 , 29 ]. The risk of developing sepsis and necrotizing enterocolitis was higher in newborns from non-TCTA triplet pregnancies, while there were no differences for severe intraventricular hemorrhage or retinopathy.…”

Conjoined twins in a spontaneous monochorionic triplet pregnancy

“…The incidences of twin and triplet pregnancies have increased gradually in recent years. [ 1 – 3 ] Conjoined twins are a complication of multiple pregnancies, and the total prevalence of conjoined twins is approximately 1.47 per 100,000 births. [ 4 ] It is extremely rare for conjoined twins to occur in a triplet pregnancy, with an incidence of nearly less than 1 in a million deliveries.…”