Neonatal functional lung maturity relative to gestational age at delivery, fetal growth, and pregnancy characteristics in triplet births

Abstract

Objective: The purpose of this study was to determine if functional lung maturity (FtLM) of triplets was affected by differentiating factors within the triplet set. Methods: This was a retrospective cohort study of triplets. Data were collected on maternal, pregnancy and neonatal characteristics and FtLM was determined, based on selected neonatal outcomes. Results: Functional lung immaturity (FtLI) was found in 35.5% of the infants and occurred in those born between 28.1 and 34.6 weeks gestation. Gestational age at delivery, pre-pregnancy BMI, and gestational diabetes were predictive of an infant having FtLM; while infertility treatment, pre-pregnancy BMI, and preeclampsia were predictors of FtLM discordance. Conclusions: Our results demonstrated FtLI was likely at early gestation (<28 weeks) and FtLM was probable beyond 35 weeks. Discordance for FtLM was likely at 32 weeks; therefore, clinicians should guard against complacency that this gestational mark assures an uncomplicated respiratory course for all infants within the set.

Keywords::

• Multiple pregnancy
• neonatal outcomes
• chronic lung disease
• respiratory distress syndrome
• preterm birth

Acknowledgements

The authors thank Amberlett Hudson, R.T., Kathy Edie, R.T., R.D.M.S., Dana Lennie, R.N., N.P., and Vicki Wasy for data collection and management and Margaret Truesdale (Department of Pathology and Laboratory Medicine at Methodist Hospital, Indianapolis, IN) for assistance in interpreting the biochemical fetal lung maturity results.

Declaration of interest: The authors report no conflict of interest.