Perinatal death of triplet pregnancies by chorionicity
| Autor: | Haruna, Kawaguchi, Keisuke, Ishii, Ryo, Yamamoto, Shusaku, Hayashi, Nobuaki, Mitsuda, Mikio, Hashiguchi |
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| Rok vydání: | 2012 |
| Předmět: |
congenital
hereditary and neonatal diseases and abnormalities medicine.medical_specialty medicine.medical_treatment Gestational Age macromolecular substances Japan Pregnancy medicine Triplet Pregnancy Birth Weight Humans Cervical cerclage Fetal Death Cerclage Cervical Retrospective Studies Ultrasonography Gynecology Fetus business.industry Obstetrics Mortality rate Obstetrics and Gynecology Retrospective cohort study Odds ratio Chorion Fetofetal Transfusion medicine.disease Pregnancy Triplet Pregnancy Complications Gestation Female business |
| Zdroj: | American journal of obstetrics and gynecology. 209(1) |
| ISSN: | 1097-6868 |
| Popis: | Objective The purpose of this study was to evaluate the perinatal risk of death by chorionicity at >22 weeks of gestation of triplet pregnancies. Study Design In a retrospective cohort study, the perinatal data were collected from triplet pregnancies in Japanese perinatal care centers between 1999 and 2009. We included maternal characteristics and examined the following factors: prenatal interventions, pregnancy outcome, and neonatal outcome. The association between fetal or neonatal death of triplets and chorionicity was evaluated by logistic regression analysis. Results After the exclusion of 253 cases, the study group comprised 701 cases: 507 trichorionic triamniotic (TT) triplet pregnancies, 144 diamniotic triamniotic (DT) triplet pregnancies, and 50 monochorionic triamniotic (MT) triplet pregnancies. The mortality rate (fetal death at >22 weeks of gestation; neonatal death) in triplets was 2.6% and included 2.1% of TT triplet pregnancies, 3.2% of DT triplet pregnancies, and 5.3% of MT triplet pregnancies. No significant risk of death was identified in DT triplet pregnancies; however, MT triplet pregnancies had a 2.6-fold greater risk (adjusted odds ratio, 2.60; 95% confidence interval, 1.17–5.76; P = .019) compared with TT triplet pregnancies. Prophylactic cervical cerclage did not reduce the perinatal mortality rate at >22 weeks of gestation in triplets. Conclusion The risk of death for MT triplet pregnancies is significantly higher than that of TT triplet pregnancies; however, the risk of death for DT triplet pregnancies is not. |
| Databáze: | OpenAIRE |
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