Prediction of Adverse Pregnancy Outcomes Based on Maternal and Pregnancy Characteristics in Triplet Pregnancies.

Objective

Multifetal gestations are linked to an increased risk of pregnancy-related hypertensive disorders and other adverse outcomes. The probability positively correlates with the number of fetuses. Therefore, the objective of the study was to assess the use of various maternal and pregnancy-related characteristics for the prediction of adverse pregnancy outcomes in triplet pregnancies, dependent on different possible predictive factors such as maternal age, BMI, assisted reproductive technology (ART), parity, uterine artery Doppler (UtA-PI) measured and chorionicity.

Methods

This was a screening study in 99 triplet pregnancies to evaluate the risk for adverse pregnancy outcomes for PE, hypertension, fetal growth restriction (FGR), intrauterine fetal death (IUFD), small for gestational age (SGA) and preterm birth below 32 + 0 gestational weeks, dependent on different possible predictive factors. Logistic regression analysis was performed.

Results

99 triplet pregnancies were included. Additionally, 58 women (58.6%) developed adverse pregnancy outcomes: FGR 16.2%, SGA (3.0%). Gestational hypertension was observed in 16 pregnancies (16.2%), and preeclampsia was diagnosed in 11 cases (11.1%). Furthermore, 6 pregnancies (6.2%) were complicated by IUFD, and 36 pregnancies (36.4%) resulted in preterm birth before 32 + 0 weeks of gestation.

Conclusions

Hypertension and PE are common maternal complications in triplet pregnancies. While higher maternal age is a clear predictor of hypertension and PE, a model based on maternal and pregnancy characteristics did not provide sufficient predictive accuracy.