Am J Perinatol 2018; 35(14): 1388-1393
DOI: 10.1055/s-0038-1660457
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Relationship of Assisted Reproductive Technology on Perinatal Outcomes in Triplet Gestations

Jaimin S. Shah
1  Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas
,
Tania Roman
2  Division of Maternal and Fetal Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, Texas
,
Oscar A. Viteri
3  Division of Maternal Fetal Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas
,
Ziad A. Haidar
3  Division of Maternal Fetal Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas
,
Alejandra Ontiveros
3  Division of Maternal Fetal Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas
,
Baha M. Sibai
3  Division of Maternal Fetal Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas
› Author Affiliations
Funding None.
Further Information

Publication History

20 October 2017

23 April 2018

Publication Date:
08 June 2018 (online)

Abstract

Objective To assess whether assisted reproductive technology (ART) is associated with increased risk of adverse perinatal outcomes in triplet gestations compared with spontaneous conception.

Study Design Secondary analysis of a multicenter randomized trial for the prevention of preterm birth in multiple gestations. Triplets delivered at ≥ 24 weeks were studied. The primary outcome was the rate of composite neonatal morbidity (CNM) that included one or more of the following: bronchopulmonary dysplasia, respiratory distress syndrome, necrotizing enterocolitis, culture proven sepsis, pneumonia, retinopathy of prematurity, intraventricular hemorrhage, periventricular leukomalacia, or perinatal death.

Results There were 381 triplets (127 women) of which 89 patients conceived via ART and 38 patients spontaneously. Women with ART were more likely to be older, Caucasian, married, nulliparous, have higher level of education, and develop pre-eclampsia. Spontaneously conceived triplets were more likely to delivery at an earlier gestation (31.2 ± 3.5 vs 32.8 ± 2.7 weeks) (p = 0.009) with a lower birth weight (p < 0.001). After adjusting for confounders, no differences were noted in culture proven sepsis, perinatal death, CNM, respiratory distress syndrome, or Apgar score < 7 at 5 minutes. All remaining perinatal outcomes were similar.

Conclusion Triplets conceived by ART had similar perinatal outcomes compared with spontaneously conceived triplets.