Trichorionic triplet pregnancy reduction to twin pregnancy is associated with a lower risk of preterm delivery but not with a lower risk of miscarriage. However, data on dichorionic triamniotic (DCTA) triplet pregnancy outcomes are lacking. This study aimed to compare the pregnancy outcomes of DCTA triplets conceived via in vitro fertilization-embryo transfer (IVF-ET) managed expectantly or reduced to a monochorionic (MC) singleton or monochorionic diamniotic (MCDA) twins at 11–13+ 6 gestational weeks. Two hundred ninety-eight patients with DCTA triplets conceived via IVF-ET between 2012 and 2016 were retrospectively analysed. DCTA triplets with three live foetuses were reduced to a MC singleton (group A) or MCDA twins (group B) or underwent expectant management (group C). Each multifoetal pregnancy reduction (MFPR) was performed at 11–13+ 6 gestational weeks. Pregnancy outcomes in the 3 groups were compared. Eighty-four DCTA pregnancies were reduced to MC singleton pregnancies, 149 were reduced to MCDA pregnancies, and 65 were managed expectantly. There were no significant differences among groups A, B, and C in miscarriage rate (8.3 vs. 7.4 vs. 10.8%, respectively) and live birth rate (90.5 vs. 85.2 vs. 83.1%, respectively) (P > 0.05). Group A had significantly lower rates of preterm birth (8.3 vs. 84.6%; odds ratio (OR) 0.017, 95% confidence interval (CI) 0.006–0.046) and low birth weight (LBW; 9.2 vs. 93.2%; OR 0.007, 95% CI 0.003–0.020) than group C (P < 0.001). Group B had significantly lower preterm birth (47.0 vs. 84.6%; OR 0.161, 95% CI 0.076–0.340) and LBW rates (58.7 vs. 93.2%; OR 0.103, 95% CI 0.053–0.200) than group C (P < 0.001). Group A had significantly lower preterm birth (8.3 vs. 47.0%; OR 0.103, 95% CI 0.044–0.237; P < 0.001), LBW (9.2 vs. 58.7%; OR 0.071, 95% CI 0.032–0.162; P < 0.001) and perinatal death rates (1.3 vs. 9.1%; OR 0.132, 95% CI 0.018–0.991; P = 0.021) than group B. The MFPR of DCTA triplets to singleton or MCDA pregnancies was associated with better pregnancy outcomes compared to expectant management. DCTA triplets reduced to singleton pregnancies had better perinatal outcomes than DCTA triplets reduced to MCDA pregnancies.

中文翻译：

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体外受精-胚胎移植后绒毛膜羊膜三联体三联体妊娠的妊娠结局：多胎妊娠减少与预期管理

将三绒毛的三体妊娠减少为双胎妊娠与较低的早产风险相关，但与较低的流产风险相关。但是，缺乏有关绒毛膜羊膜炎（DCTA）三联体妊娠结局的数据。这项研究的目的是比较通过体外受精-胚胎移植（IVF-ET）预期怀孕或减少为单绒毛膜（MC）单胎或单绒毛膜羊膜炎（MCDA）双胎的DCTA三胞胎在11-13 + 6个孕周的妊娠结局。回顾性分析2012年至2016年间通过IVF-ET构思的298例DCTA三联体患者。具有三个活胎的DCTA三胞胎被减少为MC单胎（A组）或MCDA双胞胎（B组）或接受了预期管理（C组）。每次多胎妊娠减少（MFPR）均在孕期11–13 + 6周进行。比较3组的妊娠结局。84例DCTA妊娠减少为MC单胎妊娠，149例减少为MCDA妊娠，65例得到了预期处理。A，B和C组的流产率（分别为8.3对7.4和10.8％）和活产率（分别为90.5对85.2和83.1％）没有显着差异（P> 0.05）。A组早产率显着较低（8.3比84.6％；比值比（OR）0.017，95％置信区间（CI）0.006-0.046）和低出生体重（LBW； 9.2比93.2％； OR 0.007， 95％CI（0.003–0.020）比C组（P <0.001）。B组早产率明显较低（47.0比84.6％； OR 0.161，95％CI 0.076-0.340）和LBW率（58.7 vs. 93.2％； OR 0.103，95％CI 0。053–0.200），高于C组（P <0.001）。A组早产明显较低（8.3 vs. 47.0％; OR 0.103，95％CI 0.044-0.237; P <0.001），LBW（9.2 vs. 58.7％; OR 0.071，95％CI 0.032-0.162; P <0.001 ）和围产期死亡率（1.3 vs. 9.1％； OR 0.132，95％CI 0.018–0.991； P = 0.021）高于B组。与预期管理相比，DCTA三联体单胎或MCDA妊娠的MFPR与妊娠结局更好。减少至单胎妊娠的DCTA三联症比减少至MCDA妊娠的DCTA三联症具有更好的围产期结局。021）高于B组。与预期管理相比，DCTA三胞胎对单胎或MCDA妊娠的MFPR与更好的妊娠结局相关。减少至单胎妊娠的DCTA三联症比减少至MCDA妊娠的DCTA三联症具有更好的围产期结局。021）高于B组。与预期管理相比，DCTA三胞胎对单胎或MCDA妊娠的MFPR与更好的妊娠结局相关。减少至单胎妊娠的DCTA三联症比减少至MCDA妊娠的DCTA三联症具有更好的围产期结局。