title: Prediction of perinatal mortality in triplet pregnancies.
abstract: To investigate predictors of perinatal mortality in triplet pregnancies.
  
  
  
  Retrospective cohort managed in a tertiary teaching hospital (1998-2012) including all pregnancies with tree live fetuses at the first ultrasound examination, performed after 11 weeks of gestation. Primary end-point was defined as the number of children alive at hospital discharge. Ordinal stepwise regression analysis examined the association with maternal age, parity, pregnancy chorionicity, gestational age at our first ultrasound evaluation, presence of maternal clinical, obstetrical and fetal complications and gestational age at delivery.
  
  
  
  Sixty-seven triplet pregnancies were first seen at 18.5 ± 6.8 weeks, 33 (49.3 %) were trichorionic, obstetric complications occurred in 34 (50.7 %) and fetal complications were diagnosed in 17 (25.4 %). Perinatal mortality rate was 249 ‰ (95 % CI 189-317) and 138 (73 %) children were discharged alive from hospital (11 pregnancies with no survivors; single and double survival in ten cases each; all children alive in 36). Regression analysis showed that presence of fetal complications (OR 0.10, 95 % CI 0.03-0.36) and gestational age at delivery (OR 1.55, 95 % CI 1.31-1.85) are significant predictors of outcome (p < 0.001).
  
  
  
  Perinatal mortality in non-selected triplet pregnancies is high and is related to the presence of fetal complications and gestational age at delivery.
authors.affiliation: Department of Obstetrics and Gynaecology, Hospital das Clínicas, Instituto Central, São Paulo University Medical School, 10th Floor, Suite 10037, Av Dr Enéas de Carvalho Aguiar 255, São Paulo, SP, CEP: 05403 000, Brazil.
authors.forename: Carolina B
authors.initials: CB
authors.lastname: Maia
authors.affiliation: Department of Obstetrics and Gynaecology, Hospital das Clínicas, Instituto Central, São Paulo University Medical School, 10th Floor, Suite 10037, Av Dr Enéas de Carvalho Aguiar 255, São Paulo, SP, CEP: 05403 000, Brazil. adolfo.liao@gmail.com.
authors.forename: Adolfo W
authors.initials: AW
authors.lastname: Liao
authors.affiliation: Department of Obstetrics and Gynaecology, Hospital das Clínicas, Instituto Central, São Paulo University Medical School, 10th Floor, Suite 10037, Av Dr Enéas de Carvalho Aguiar 255, São Paulo, SP, CEP: 05403 000, Brazil.
authors.forename: Maria L
authors.initials: ML
authors.lastname: Brizot
authors.affiliation: Department of Obstetrics and Gynaecology, Hospital das Clínicas, Instituto Central, São Paulo University Medical School, 10th Floor, Suite 10037, Av Dr Enéas de Carvalho Aguiar 255, São Paulo, SP, CEP: 05403 000, Brazil.
authors.forename: Rossana P V
authors.initials: RP
authors.lastname: Francisco
authors.affiliation: Department of Obstetrics and Gynaecology, Hospital das Clínicas, Instituto Central, São Paulo University Medical School, 10th Floor, Suite 10037, Av Dr Enéas de Carvalho Aguiar 255, São Paulo, SP, CEP: 05403 000, Brazil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Zugaib
mesh_terms: D000328:Adult; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D054238:Perinatal Mortality; D011247:Pregnancy; D059286:Pregnancy, Triplet; D012189:Retrospective Studies
keywords: Multiple pregnancy; Perinatal mortality; Pregnancy complications; Risk factors; Triplet; Ultrasonography