WEIGHT GROWTH CHARTS FOR TRIPLETS: CROSS-SECTIONAL MULTI-CENTRIC STUDY

Objectives: To analyze characteristics and outcome of triplet pregnancies without embryo reduction, to compare their growth charts with twins, and to draw specific growth charts based on neonatal weight. Materials: We retrospectively analyzed 44 pregnancies and 132 neonates, who were delivered between 2001 and 2010 in two third level Clinics of North-East Italy. Methods: We compared triplets growth pattern with 1534 twins born in the same centers during the same period. Data was analyzed by R (version 2.14.1), considering significant p < 0.05. Results: The mean maternal age of women with triplets was 33.4 years (±3.4). The mean gestational age at delivery was 33.3 weeks (±3.4) and the fetal weight of triplets was 1572 grams (±477). In addition, 16% of triplets delivered before 28 weeks, 50% between 28 and 34 weeks, and 34% between 34 and 37 weeks. In both centers any patients from Sub-Saharan Africa (around 9% of pregnant women) had triplets and 70% of the cases was treated with procreation assisted technology. We compared twin growth charts with triplets and we found a significant difference (p < 0.001). Then, we compared among the triplets the growth charts of males and females (p 0.053). Considering the triplets and comparing our growth chart with the twins we noted a plateau of growth in triplets around 32 weeks while twins were still growing until delivery (in all cases at or before 39 weeks of gestation). Conclusions: We found a pattern of fetal growth in triplet different from twin and singleton pregnancies. Therefore, it is our opinion that to better monitor triplets without embryo reduction (to find those at high risk for SGA and IUGR) there is the need of specific growth chats like the one we suggest.