title: Neonatal outcomes in triplet pregnancies: assisted reproduction versus spontaneous conception.
abstract: OBJECTIVE
  The purpose of this study is to compare neonatal outcomes of spontaneously conceived triplets with triplets conceived by assisted reproduction.
  
  
  METHODS
  This was a retrospective cohort study of all cases from assisted triplet pregnancies and controls from spontaneous triplet pregnancies. A total of 24 triplet pregnancies were studied: six spontaneous and 18 assisted. The following variables were evaluated in all newborns: prematurity, birth-weight, small for gestational age, birth-weight discordance, Apgar scores, major neonatal morbidity and perinatal mortality.
  
  
  RESULTS
  Gestational age (33+/-1 vs. 33+/-2 weeks) and birth-weight (1760+/-256 vs. 1907+/-452 g) were similar in spontaneous and assisted triplet pregnancies. There were no significant differences in the rates of small for gestational age, discordance, and major neonatal morbidity. In the assisted reproduction group only the following cases were recorded: 1 surgically treated patent ductus arteriosus, 1 feto-fetal transfusion syndrome, 2 grade II intraventricular hemorrhage, 1 Cri du Chat syndrome and 1 stillbirth with malformations.
  
  
  CONCLUSIONS
  This study is unable to assess the influence of assisted reproduction on the neonatal outcomes of triplet pregnancies. However, the results suggest that the incidence of major neonatal morbidity, especially malformations, might increase due to assisted reproduction. This finding requires further confirmation.
authors.affiliation: Department of Neonatology, Catholic University of the Sacred Heart, Rome, Italy. zuppaaa@rm.unicatt.it
authors.forename: Antonio A
authors.initials: AA
authors.lastname: Zuppa
authors.forename: Antonio
authors.initials: A
authors.lastname: Scorrano
authors.forename: Francesco
authors.initials: F
authors.lastname: Cota
authors.forename: Vito
authors.initials: V
authors.lastname: D'Andrea
authors.forename: Annalisa
authors.initials: A
authors.lastname: Fracchiolla
authors.forename: Costantino
authors.initials: C
authors.lastname: Romagnoli
mesh_terms: D001724:Birth Weight; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D009017:Morbidity; D011247:Pregnancy; D011256:Pregnancy Outcome; D027724:Reproductive Techniques, Assisted / Q000009:adverse effects; D012189:Retrospective Studies; D014310:Triplets