Abstract：
OBJECTIVE: Triplet pregnancies involve several complications, the most important being prematurity as virtually all triplets are born preterm. We conducted this study to compare the outcomes of reduced vs. non-reduced triplet pregnancies managed in the largest tertiary hospital in Finland.
METHODS: This was a retrospective cohort study in the Helsinki University Hospital during 2006-2020. Data on the pregnancies, parturients and newborns were collected from patient records. The fetal number, chorionicity and amnionicity were defined in first-trimester ultrasound screening. The main outcome measures were perinatal and neonatal mortality of non-reduced triplets, compared to twins and singletons selectively reduced of triplet pregnancies.
RESULTS: There were 57 initially triplet pregnancies and 35 of these continued as non-reduced triplets and resulted in the delivery of 104 liveborn children. The remaining 22 cases were spontaneously or medically reduced to twins (9) or singletons (13). Most (54.4 %) triplet pregnancies were spontaneous. There were no significant differences in gestational age at delivery between triplets (mean 33+0, median 34+0) and those reduced to twins (mean 32+5, median 36+0). The survival at one week of age was higher for triplets compared to twins (p<0.00001).
CONCLUSIONS: Most pregnancies continued as non-reduced triplets, which were born at a similar gestational age but with a significantly higher liveborn rate compared to those reduced to twins. There were no early neonatal deaths among cases reduced to singletons. Prematurity was the greatest concern for multiples in this cohort, whereas the small numbers may explain the lack of difference in gestational age between these groups.
METHODS: This was a retrospective cohort study in the Helsinki University Hospital during 2006-2020. Data on the pregnancies, parturients and newborns were collected from patient records. The fetal number, chorionicity and amnionicity were defined in first-trimester ultrasound screening. The main outcome measures were perinatal and neonatal mortality of non-reduced triplets, compared to twins and singletons selectively reduced of triplet pregnancies.
RESULTS: There were 57 initially triplet pregnancies and 35 of these continued as non-reduced triplets and resulted in the delivery of 104 liveborn children. The remaining 22 cases were spontaneously or medically reduced to twins (9) or singletons (13). Most (54.4 %) triplet pregnancies were spontaneous. There were no significant differences in gestational age at delivery between triplets (mean 33+0, median 34+0) and those reduced to twins (mean 32+5, median 36+0). The survival at one week of age was higher for triplets compared to twins (p<0.00001).
CONCLUSIONS: Most pregnancies continued as non-reduced triplets, which were born at a similar gestational age but with a significantly higher liveborn rate compared to those reduced to twins. There were no early neonatal deaths among cases reduced to singletons. Prematurity was the greatest concern for multiples in this cohort, whereas the small numbers may explain the lack of difference in gestational age between these groups.
摘要：
目的：三胎妊娠涉及多种并发症，最重要的是早产，因为几乎所有三胞胎都是早产。我们进行了这项研究，以比较减少与减少的结果非减少三胎妊娠在芬兰最大的三级医院管理。
方法：这是2006-2020年在赫尔辛基大学医院进行的一项回顾性队列研究。怀孕数据，从患者记录中收集产妇和新生儿。胎儿数,在妊娠早期超声筛查中定义绒毛膜性和羊膜性。主要结局指标为非还原三胞胎围产期和新生儿死亡率,与双胞胎和单胎相比，三胎妊娠的选择性减少。
结果：有57例最初的三胞胎怀孕，其中35例继续为非还原三胞胎，并导致104例活产婴儿分娩。其余22例自发或医学上减少为双胞胎（9）或单胎（13）。大多数（54.4%）三胎妊娠是自发的。三胞胎（平均33+0，中位数34+0）和降低为双胎（平均32+5，中位数36+0）之间的孕龄没有显着差异。与双胞胎相比，三胞胎在一周大时的存活率更高（p<0.00001）。
结论：大多数妊娠继续为非还原三胞胎，出生在相似的胎龄，但与减少到双胞胎的人相比，活产率显着更高。在单例病例中，没有早期新生儿死亡。早产是这个群体中倍数最大的担忧，而数量较少可以解释这些组之间缺乏胎龄差异的原因。
方法：这是2006-2020年在赫尔辛基大学医院进行的一项回顾性队列研究。怀孕数据，从患者记录中收集产妇和新生儿。胎儿数,在妊娠早期超声筛查中定义绒毛膜性和羊膜性。主要结局指标为非还原三胞胎围产期和新生儿死亡率,与双胞胎和单胎相比，三胎妊娠的选择性减少。
结果：有57例最初的三胞胎怀孕，其中35例继续为非还原三胞胎，并导致104例活产婴儿分娩。其余22例自发或医学上减少为双胞胎（9）或单胎（13）。大多数（54.4%）三胎妊娠是自发的。三胞胎（平均33+0，中位数34+0）和降低为双胎（平均32+5，中位数36+0）之间的孕龄没有显着差异。与双胞胎相比，三胞胎在一周大时的存活率更高（p<0.00001）。
结论：大多数妊娠继续为非还原三胞胎，出生在相似的胎龄，但与减少到双胞胎的人相比，活产率显着更高。在单例病例中，没有早期新生儿死亡。早产是这个群体中倍数最大的担忧，而数量较少可以解释这些组之间缺乏胎龄差异的原因。
