Abstract / Summary
Abstract Background: Triplet pregnancies are associated with high rates of prematurity, low birth weight, and neonatal morbidity. However, the influence of fetal reduction and chorionicity on perinatal and follow-up outcomes remains uncertain. This study aimed to describe maternal, obstetric, neonatal, and follow-up outcomes of triplet pregnancies and to evaluate outcomes according to fetal reduction status and chorionicity. Methods: This retrospective cohort study included 60 triplet pregnancies between January 2020 and November 2025. Maternal, obstetric, neonatal, and follow-up data were analyzed according to fetal reduction status and chorionicity. Results: Fetal reduction was performed in 22 pregnancies (36.7%). Pregnancies managed with fetal reduction had a higher gestational age at delivery (34.1 ± 3.5 vs. 31.1 ± 3.6 weeks, p=0.008). Infants in the reduction group had greater birth weights (1994.5 ± 610.0 g vs. 1469.2 ± 548.3 g, p<0.001) and lower rates of low birth weight (71.4% vs. 97.6%, p<0.001), neonatal intensive care unit admission (67.9% vs. 91.7%, p=0.004), and retinopathy of prematurity (0.0% vs. 20.8%, p=0.009). Survival at last available follow-up was numerically higher following fetal reduction (96.4% vs. 80.5%, p=0.069). Survival rates according to chorionicity were 63.6%, 84.3%, and 88.7% in monochorionic, dichorionic, and trichorionic pregnancies, respectively (p=0.115). Conclusions: Fetal reduction was associated with later delivery and improved short-term neonatal outcomes. These findings highlight the importance of considering both fetal reduction status and chorionicity when counseling and managing triplet pregnancies.