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Preterm delivery in triplet pregnancies.

Armin S Razavi¹, Robin B Kalish¹, Shannon Coombs¹

¹a Department of Obstetrics and Gynecology, Maternal Fetal Medicine, Weill Cornell Medical College , New York, NY , USA.

The Journal of Maternal-Fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians

|November 5, 2016

Summary

In triplet pregnancies, indicated preterm birth (IPTB) and spontaneous preterm birth (SPTB) occurred equally. Parity was a key factor, with parous women less likely to deliver preterm.

Keywords:

Preterm birth multiple gestation triplets

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Area of Science:

Maternal-Fetal Medicine
Reproductive Science
Obstetrics

Background:

Triplet pregnancies face higher risks of preterm birth compared to singleton or twin gestations.
Understanding the distinct pathways to preterm delivery in triplets is crucial for optimizing perinatal outcomes.
Spontaneous preterm birth (SPTB) and indicated preterm birth (IPTB) represent different etiological and management scenarios.

Purpose of the Study:

To compare the incidence of spontaneous preterm birth (SPTB) versus indicated preterm birth (IPTB) in triplet pregnancies.
To identify clinical factors associated with SPTB and IPTB in this high-risk obstetric population.
To evaluate the impact of parity on preterm delivery outcomes in women carrying triplets.

Main Methods:

Retrospective review of triplet pregnancies delivering between 2003 and 2015.
Exclusion of deliveries before 24 weeks gestational age.
Classification of preterm births into SPTB (preterm labor or PPROM) and IPTB (maternal/fetal indications).

Main Results:

Out of 80 triplet pregnancies, 18 (22.5%) reached term.
In the remaining 62 pregnancies, 31 (49.2%) experienced IPTB and 31 (49.2%) experienced SPTB.
Parity was significantly associated with reaching term (56.3% parous vs. 14.1% nulliparous, p=0.001).
No significant differences were found in maternal age, chorionicity, or ART use between SPTB and IPTB groups.

Conclusions:

In triplet pregnancies, indicated preterm birth (IPTB) occurs with the same frequency as spontaneous preterm birth (SPTB).
Parous women demonstrate a reduced likelihood of both SPTB and indicated preterm delivery.
These findings highlight the importance of parity in predicting preterm birth risk in triplet gestations.