Search Results (270)

Introduction: Human breast milk (HBM) is a critical source of nourishment for newborns, containing bioactive compounds that influence infant growth and metabolic programming. Among these compounds, leptin—a hormone primarily produced by adipocytes but also synthesized in the mammary gland—has gathered attention for its potential role in regulating energy balance and body weight. This study investigates the influence of maternal factors on HBM leptin concentrations and explores their associations with neonatal growth parameters. Material and Methods: 262 HBM samples were collected from healthy lactating mothers through Spanish Biobanks during the first six months postpartum. Data on maternal characteristics (body mass index (BMI), age, physical activity, parity, and delivery type) and neonatal measurements (weight, length, and head circumference) were collected. Leptin concentrations in skimmed HBM were measured using the ELISA technique (R&D Systems™, Minneapolis, MN, USA). Statistical analyses were conducted using R version 4.3.1 and MATLAB R2023a, with significance set at p < 0.05. Results: Leptin levels were highest in and declined over time, reaching a stable level after the first month of lactation. Preterm deliveries exhibited significantly higher leptin concentrations than term deliveries (0.42 vs. 0.07 ng/mL). Higher leptin levels were also observed in younger and primiparous mothers. Maternal BMI was positively associated with leptin concentration, with mothers who had elevated BMI showing higher levels than those with optimal BMI (0.36 vs. 0.05 ng/mL). Maternal physical activity was not associated with leptin concentrations in univariate analyses; although greater self-reported physical activity appeared associated with lower leptin concentrations in regression models, this finding should be interpreted cautiously and should not be considered evidence of an independent or consistent effect. Neonatal growth parameters (weight, length, and head circumference) were negatively correlated with HBM leptin concentrations. Conclusions: Our findings indicate that leptin levels in breast milk reflect both maternal metabolic status and neonatal characteristics and may represent a compensatory mechanism in preterm infants. HBM leptin levels are modulated by maternal BMI, age, parity, and delivery type, and are associated with neonatal growth parameters. Full article

Background/Objectives: To construct and compare multivariable prediction models for the early prediction of large-for-gestational-age (LGA) neonates, using ultrasound biometry and maternal characteristics. Methods: This retrospective cohort study analyzed data from singleton pregnancies that underwent routine ultrasound examinations at 30⁺⁰–34⁺⁰ weeks of gestation. Ultrasound parameters included fetal abdominal circumference (AC), head circumference (HC), femur length (FL), HC-to-AC ratio, mean uterine artery pulsatility index (mUtA-PI), and presence of polyhydramnios. LGA neonates were defined as those having a birthweight > 90th percentile. Logistic regression was used to evaluate associations between ultrasound markers and LGA after adjusting for the following maternal and pregnancy-related covariates: maternal age, body mass index, parity, gestational diabetes mellitus (GDM), pre-existing diabetes, previous cesarean section (PCS), assisted reproductive technology (ART) use, smoking, hypothyroidism, and chronic hypertension. Associations were expressed as adjusted odds ratios (aORs) with 95% confidence intervals (CIs). Three prognostic models were developed utilizing the following predictors: (i) biometric ultrasound measurements including AC, HC-to-AC ratio, FL, UtA-PI, and polyhydramnios (Model 1), (ii) a combination of biometric ultrasound measurements and clinical–maternal data (Model 2), and (iii) only the estimated fetal weight (EFW) (Model 3). Results: In total, 3808 singleton pregnancies were included in the analyses. The multivariable analysis revealed that AC (aOR 1.07, 95% CI [1.06, 1.08]), HC to AC (aOR 1.01, 95% CI [1.006, 1.01]), FL (aOR 1.01, 95% CI [1.009, 1.01]), and the presence of polyhydramnios (aOR 4.97, 95% CI [0.7, 58.8]) were associated with an increased risk of LGA, while a higher mUtA-PI was associated with a reduced risk (aOR 0.98, 95% CI [0.98, 0.99]). Maternal parameters, such as GDM, pre-existing diabetes, elevated pre-pregnancy BMI, absence of uterine artery notching, mUtA-PI, and multiparity, were significantly higher in the LGA group. Both models 1 and 2 showed similar performance (AUCs: 84.7% and 85.3%, respectively) and outperformed model 3 (AUC: 77.5%). Bootstrap and temporal validation indicated minimal overfitting and stable model performance, while decision curve analysis supported potential clinical utility. Conclusions: Models using biometric and Doppler ultrasound at 30–34 weeks demonstrated good discriminative ability for predicting LGA neonates, with an AUC up to 84.7%. Adding maternal characteristics did not significantly improve performance, while the biometric model performed better than EFW alone. Sensitivity at conventional thresholds was low but increased substantially when lower probability cut-offs were applied, illustrating the model’s threshold-dependent flexibility for early risk stratification in different clinical screening needs. Although decision curve analysis was performed to explore potential clinical utility, external validation and prospective assessment in clinical settings are still needed to confirm generalizability and to determine optimal decision thresholds for clinical application. Full article

Background/Objectives: The impact of choline on congenital heart defects (CHDs) in humans remains unclear. This study aimed to investigate the associations between maternal dietary intakes of choline and choline derivatives during pregnancy and CHD. Methods: This case–control study included 474 cases and 948 controls from hospitals in Northwest China. Pregnant women admitted for delivery were enrolled and completed a validated food frequency questionnaire to assess their dietary intake during pregnancy. A standardized questionnaire was also administered to collect additional pregnancy-related information. Mixed logistic regression models were used to estimate ORs (95%CIs) for CHD in association with choline intake. Results: Higher intakes of total choline, phosphatidylcholine, sphingomyelin, glycerophosphocholine, and phosphocholine in pregnancy were associated with reduced risks of total CHD, ventricular septal defects, and atrial septal defects, with all trend tests showing statistical significance (all p < 0.05). The ORs (95%CIs) of total CHD, comparing the highest with the lowest tertiles of intake, were 0.38 (0.24–0.61) for total choline, 0.51 (0.38–0.70) for phosphatidylcholine, 0.37 (0.26–0.51) for sphingomyelin, 0.34 (0.21–0.53) for glycerophosphocholine, and 0.53 (0.34–0.82) for phosphocholine. The inverse associations remained unchanged according to maternal age, work, education, parity, passive smoking, anemia, medication use, or folate/iron supplements use in pregnancy; however, these associations appeared to be more pronounced among pregnant women in urban areas. Conclusions: Higher maternal intake of dietary choline during pregnancy may be associated with a lower risk of CHD. Promoting choline intake in pregnant women could serve as a potential strategy for the primary prevention of fetal CHD in China. Full article

The present study evaluated the impact of precision feeding using Electronic Sow Feeders (ESFs) during lactation on the nutritional status of Iberian sows and the performance of their offspring under intensive farming conditions. Fifty-three second-parity Iberian sows were assigned to three feeding systems: ESFs (PF), feeding ball (FB), and conventional feeders (CON). Results showed that PF sows had a significantly lower feed disappearance, without affecting body weight and condition, when compared to FB and CON groups (p < 0.05). Although milk yield did not differ significantly among groups, PF piglets exhibited higher weaning weights and average daily weight gains (ADWG), particularly during the second half of lactation (p < 0.05 and p < 0.001, respectively). Metabolic profiling revealed an improved glucose and lipid homeostasis in PF sows, with lower Non-Esterified Fatty Acids (NEFAs) levels and more favorable cholesterol profiles (p < 0.05 for all). No remarkable differences were observed in welfare biomarkers (salivary cortisol and alpha-amylase) among treatments. These findings suggest that precision feeding enhances feed efficiency, stabilizes maternal metabolism, and improves piglet growth in traditional swine breeds (“fatty pigs”) like the Iberian pig, offering a sustainable strategy for intensifying production without compromising animal welfare. Full article

Background: Dysregulation of the hypothalamic–pituitary–adrenal axis is implicated in both gestational diabetes mellitus (GDM) and mood disorders, suggesting a shared pathophysiology. However, the impact of GDM on maternal depressive symptoms, particularly among women with “low and late” fertility, remains poorly characterized. Methods: We compared the risk of postpartum depressive symptoms, assessed on the second postpartum day using the Edinburgh Postnatal Depression Scale (EPDS), with a cut-off score ≥ 12, and the Anhedonia, Anxiety, and Depression subscales, between Northeast Italian women with GDM and control participants with normal oral glucose tolerance tests (OGTT), classified as having “low and late fertility”. Results: Among the 2560 women included in the analysis, 231 (9.02%) had GDM. Compared with controls with normal OGTT, women with GDM were older (36.0 vs. 33.0 years, p < 0.001) and had higher pre-pregnancy BMI (23.4 vs. 21.6 kg/m², p < 0.001), but lower gestational weight gain (GWG) (11.0 vs. 13.0 kg, p < 0.001), with no difference in parity [2.00 vs. 1.00, p = 0.5. In addition, GDM was not associated with increased postpartum depressive symptoms (15% EPDS scores ≥12 in both groups, p > 0.9) or with Anhedonia, Anxiety, or Depression subscale scores (p = 0.7). Conclusions: Advanced maternal age and reduced parity, hallmarks of women postponing childbearing, do not appear to confer an increased risk of early postpartum mood comorbidities in the context of GDM. Promoting healthy physical and mental well-being among women in this demographic category requires integrated strategies encompassing nutrition, healthcare, and education. Full article

Steroid hormones (SHs), including sex steroids and corticosteroids, are crucial for a healthy pregnancy. We aimed to comprehensively characterize the maternal SH metabolome in late pregnancy and identify clinical, lifestyle, and sociodemographic determinants influencing SH metabolism with a replication in an independent cohort. Urinary SH metabolites were analyzed in 1221 third-trimester pregnant women (aged 28 to 37 years) from two Spanish cohorts, BiSC (2018–2021, n = 721) and INMA-Sabadell (2004–2006, n = 500), using targeted UHPLC-MS/MS. We quantified 50 SH metabolites, resulting in 13 hormone groups, 9 sulfate/glucuronide ratios, and 17 estimated steroid enzymatic activities across steroidogenesis pathways. We applied elastic net regression to identify determinants, and multivariable linear regression models to estimate variance explained. Among the 47 and 28 determinants from BiSC and INMA-Sabadell, respectively, 10 determinant-SH metabolome pairs showed statistically significant associations (p < 0.05), supporting robust replication. Maternal BMI was the main determinant linked to higher corticosteroid and androgen metabolites. Higher physical activity was associated with lower glucocorticoids and progestogen metabolites, while older maternal age was related with lower levels of androgen and corticosteroid metabolites. Tobacco exposure in the first trimester predicted higher levels of cortisol metabolites. Latin American women had lower cortolone levels compared with Spanish women. Parity, dietary fat intake, sleep, alcohol intake, and sex of the fetus contributed to smaller variations in different SHs. This dual-cohort analysis provides the most detailed and replicated evidence to date of how clinical, lifestyle, and sociodemographic factors shape the maternal SH metabolome during late pregnancy. Full article

Urinary tract infections (UTIs) are linked to adverse pregnancy outcomes, yet epidemiological data on gestational UTIs in Kenya are limited. This study assessed diagnostic and management practices in Kisumu County to inform diagnostic and antimicrobial stewardship. A hospital-based retrospective study was conducted from February 2020 to February 2021 among 416 records of pregnant women at Chulaimbo and Nyahera Sub-County Hospitals. Socio-demographic, laboratory, and clinical history data were collected using structured forms and analysed in STATA 16.0. Statistical methods included chi-square, multivariate logistic regression, and Spearman’s rank correlation (p ≤ 0.05). Dipstick-based presumptive proportion of UTIs was 57.9% (241/416). Only 1.4% (6/416) had microbiological confirmation despite infections being recorded. The mean maternal age was 23.92 years, parity two, mean antenatal visits two, and mean haemoglobin 10.73 ± 1.8 g/dL. The first antenatal care attendance occurred at varying gestational ages in 56% (233/416). Antibiotics prescribed were 60% from WHO ‘Access’ group and 40% from ‘Watch’ group. Gestational UTI’s in Kisumu County were frequently managed without confirmatory diagnosis, increasing antimicrobial resistance risk. Strengthening management requires better laboratory capacity, sustained financial investment, improved antibiotic access, and adherence to WHO AWaRe guidelines to protect maternal and neonatal health. Full article

Background/Objectives: Diabetes mellitus (DM) in pregnancy, including type 1 (T1DM), type 2 (T2DM), and gestational DM (GDM), represents an increasing health burden due to its maternal and fetal complications. Despite the increment in the global prevalence estimates of DM in pregnancy, in Romania, it has not been comprehensively described. This study aimed to analyze the prevalence and dynamics of DM in pregnancy in Romania between 2014 and 2024, using national databases, and to identify prevention strategies for reducing maternal and fetal complications. Methods: Data were obtained from the Romanian National Public Health Institute through two distinct sources: Database 1, consisting of reports from public and medical units associated with the National Health Insurance House and Database 2, based on the reports from general practitioners. Pregnancies complicated by DM were assessed by type, age group, and environmental settlement. Additional data were extracted on pregnancies with insufficient prenatal care and those of socially vulnerable individuals. Results: From 2014 to 2024, the prevalence of DM in pregnancy in Romania was consistently lower than European and global estimates, ranging from 1.01‰ to 3.08‰ in Database 1 and from 0.84‰ to 5.88‰ in Database 2, respectively. GDM accounted for the majority of cases, accounting for 65–88% of reported DM in pregnancy. The highest incidence was observed in the 20–39 years age group, with a growing proportion in women aged ≥40 years. Urban-rural disparities decreased over the decade, with rural cases reaching parity by 2024. Vulnerable populations included adolescents, women with insufficient prenatal care, and those with social risk factors, predominantly from rural areas. Conclusions: Although the reported prevalence of DM in pregnancy in Romania is lower than international figures, the true burden is likely underestimated. GDM remains the leading type of DM in pregnancy, mirroring global trends. Strengthening the reporting system, standardizing diagnostic criteria, and targeting high-risk groups through preconceptional counselling, lifestyle interventions, advanced monitoring technologies, and improving social support through the involved authorities are crucial steps to reduce maternal and fetal morbidity. Full article

Background: We aimed to compare the perinatal outcomes of dichorionic/diamniotic twin (DC/DA) pregnancies resulting from in vitro fertilization (IVF) with those resulting from spontaneous DC/DA pregnancies. Methods: The study group included 99 women with DC/DA pregnancies resulting from IVF, and the control group included 92 women with spontaneous DC/DA pregnancies. Maternal demographic characteristics (age, parity, and gravidity), pre-existing conditions (chronic hypertension and pregestational diabetes mellitus), and obstetric history were recorded. Pregnancy outcomes included gestational age at delivery, number of fetuses, and mode of delivery. The antepartum complications that we evaluated include first- and second-trimester bleeding, placenta previa, preterm birth, fetal growth restriction (FGR), oligohydramnios, and tocolytic use. The obstetric complications that we assessed include prematurity, twin-to-twin transfusion syndrome (TTTS), and hydrops fetalis. Additionally, neonatal data such as 1st minute and 5th minute Apgar scores, birth weight, neonatal intensive care unit (NICU) admission, presence of congenital anomalies, and neonatal death were recorded, and comparisons were made between the groups. Results: Women in the IVF group were older (34.7 ± 6.9 vs. 32.3 ± 6.1 years, p = 0.03) and more frequently primiparous (73.7% vs. 37.0%, p < 0.001). The mean gestational age at delivery was slightly lower in the IVF group, though this was not statistically significant (34.3 ± 3.5 vs. 35.1 ± 2.5 weeks, p = 0.101). Cesarean delivery was common in both groups, with comparable overall rates (90.9% vs. 94.6%, p = 0.411), but emergency cesarean section occurred more frequently in IVF pregnancies (81.8% vs. 55.8%, p = 0.001). No significant differences were found regarding chronic hypertension or pregestational diabetes. However, several differences were demonstrated in terms of obstetric complications. For example, preterm births and fetal growth restriction (FGR) were significantly more frequent in IVF pregnancies (59.8% vs. 30.4%, p < 0.001), and tocolytic use was also more frequent (56.6% vs. 29.7%, p < 0.001). No significant differences were observed in terms of placenta previa, oligohydramnios, TTTS, hydrops fetalis, and neonatal outcomes. The logistic regression analysis revealed that IVF pregnancies were associated with an increased risk of preterm birth: OR 3.45, 95% CI 1.85–6.78 (p < 0.001); the risk of FGR was also higher in IVF pregnancies: OR 2.11, 95% CI 1.02–4.37 (p = 0.015). However, tocolytic use was not significantly associated with IVF: OR 1.49, 95% CI 0.50–4.44 (p = 0.471). Conclusions: Although DC/DA pregnancies conceived through IVF have a higher risk of preterm birth, fetal growth restriction, and greater use of tocolytic agents than spontaneous DC/DA pregnancies, their neonatal outcomes are similar. Full article

Background/Objectives: Myomectomy is the preferred treatment for women with uterine fibroids who desire to preserve their fertility. This study aimed to compare perinatal outcomes between Mexican women with and without a history of myomectomy, matched in a 1:2 ratio based on maternal age and parity. Methods: A retrospective cohort study was conducted involving women with and without a history of myomectomy who received prenatal care and delivered at a tertiary care hospital in Mexico City. Women with comorbidities such as pregestational diabetes, chronic hypertension, autoimmune diseases, nephropathy, cardiomyopathy, and cancer were excluded from the study. Group 1 consisted of women with a history of myomectomy, and Group 2 included matched women without such a history. The following perinatal outcomes were evaluated: miscarriage, preterm birth, cesarean section, obstetric hemorrhage, placenta previa, surgical adhesions, and obstetric hysterectomy. Adjusted relative risk (aRR) with 95% confidence intervals (CI) was calculated. Results: A total of 122 women were analyzed in group 1, and 244 in group 2. The risk of obstetric hemorrhage aRR 7.5 (95% CI 3.9–11.9), surgical adhesions aRR 11.8 (5.3–20.7), and placenta accreta aRR 15.3 (1.3–111) were significantly higher in Group 1 compared to Group 2. Other outcomes, including miscarriage, preterm birth, cesarean section, placenta previa, and obstetric hysterectomy, were similar between groups. Conclusions: Mexican pregnant women with a history of myomectomy have a higher risk of obstetric hemorrhage, surgical adhesions, and placenta accreta compared to those without such a history. Full article

Background/Objectives: Zinc deficiency remains a public health concern in South Asia but is rarely studied through gestation to infancy. Methods: We identified maternal and infant factors related to plasma zinc of 3 mo old Bangladeshi infants (n = 317) in the context of a trial of a daily antenatal to 3 mo postpartum multiple micronutrient supplementation (MMS) with 15 vitamins and minerals, including 12 mg zinc, versus iron–folic acid (IFA). Factors explored included maternal age, parity, and plasma zinc in early (pre-supplementation) and late pregnancy, at 3 months postpartum, and in milk; cord blood zinc (n = 83); birth outcomes; and infant feeding and biomarkers. Consequently, infant zinc was explored with 3 mo anthropometry and growth rates. Results: Mean ± SD infant plasma zinc was 15.63 ± 6.65 µmol/L, with 10.1% deficiency (<9.9 µmol/L). In adjusted analyses, infant zinc was positively associated with maternal age [20–30 years +0.11 µmol/L (p = 0.018) and ≥30 years +0.28 µmol/L (p = 0.003) relative to <20 years], maternal early pregnancy zinc (+0.01 µmol/L per 1 µmol/L maternal zinc, p = 0.011), and infant ferritin (+0.001 µmol/L per 1 µg/L, p = 0.007); conversely, infant zinc was −0.13 µmol/L lower (p = 0.013) with maternal parity ≥2 versus 0–1 and with partial versus exclusive breastfeeding (−0.15 µmol/L, p = 0.038). Relationships with MMS, maternal later pregnancy, postpartum, milk, and cord blood zinc were absent. Length-for-age (+0.02 per µmol/L, p = 0.047) but not weight-for-length Z-scores at 3 months were associated with infant zinc. Conclusions: Thus, infant zinc was associated with pre- but not post-MMS maternal zinc, age and parity, feeding style, and infant iron status. Infant length but not weight was associated with plasma zinc. Full article

Background/Objectives: The association between gestational weight gain (GWG) and adverse outcomes in individuals with gestational diabetes mellitus (GDM) and obesity remains unclear. This study aimed to evaluate the relationship between total GWG and maternal, obstetric, and neonatal outcomes in patients with GDM, stratified by obesity class. Methods: This retrospective cohort included 695 pregnant individuals with GDM treated at a tertiary university hospital in Brazil between 2007 and 2021. GWG was categorized as insufficient, adequate, or excessive per National Academy of Medicine guidelines. Outcomes included maternal, obstetric, and neonatal events. Analyses were conducted for the entire cohort and stratified by obesity class (I and II/III), using multivariate regression models adjusted for maternal age, parity, and pre-pregnancy BMI. Results: The mean age was 33.6 (SD 5.7) years. GWG was insufficient in 33.2%, adequate in 28.2%, and excessive in 37.8%. Excessive GWG was associated with increased odds of cesarean delivery (OR 1.69; 95% CI 1.15–2.48) and large-for-gestational-age newborns (OR 3.29; 95% CI 1.61–6.46). As a continuous variable, GWG was positively associated with cesarean delivery (OR 1.04), LGA (OR 1.10), and birthweight (β = 0.02). Lower GWG was independently associated with reduced preeclampsia risk (OR 1.09 per kg). Insufficient GWG was not linked to increased risk of small-for-gestational-age newborns or other adverse outcomes and was associated with lower insulin requirement. Results remained consistent across obesity subgroups, except for cesarean delivery in class II/III obesity. Conclusions: In individuals with GDM and obesity, insufficient GWG was not associated with increased adverse outcomes, while excessive GWG was consistently linked to unfavorable maternal and neonatal risks. Stricter GWG control may be safe and beneficial in this population. Full article

Background/Objectives: Gestational diabetes mellitus (GDM) is a common pregnancy complication, and maternal diet before conception may be an important modifiable risk factor. This study aimed to investigate the association between maternal pre-pregnancy energy and macronutrient intake and the risk of GDM. Methods: Data from the BORN2020 cohort in Northern Greece were used. Women were recruited at their first trimester prenatal visit (11–13 weeks of gestation) and provided detailed dietary data via a validated food frequency questionnaire (FFQ), reflecting intake in the six months prior to conception. Weighted Quantile Sum (WQS) regression models were applied to assess the joint effects of food-derived macronutrient mixtures on GDM risk. Analyses were adjusted for parity, maternal age, pre-pregnancy BMI, thyroid disorders, smoking, energy intake, and physical activity. Results: In total, 797 women were included in the analyses. In normal-BMI women, higher pre-pregnancy intake of energy (aOR = 81.16, 95% CI: 4.55–1447.46), total carbohydrates (aOR = 50.66, 95% CI: 3.59–715.04), total fat (aOR = 9.35, 95% CI: 1.17–74.54), and total protein (aOR = 11.06, 95% CI: 1.14–107.09) were significantly associated with increased odds of GDM. The main contributing foods were energy-dense and processed items such as puff pastry, processed meats, potatoes, refined grains, and dairy products. In contrast, dietary fiber, vegetable protein, and animal protein were not significantly associated with GDM risk. Among overweight and obese women, none of the macronutrient or energy mixtures showed significant associations. Conclusions: For women of normal weight, a pre-conception diet high in energy and macronutrients from processed foods is a significant predictor of GDM risk. This association was not found in overweight or obese women, highlighting a critical window for targeted nutritional intervention for normal-weight individuals before pregnancy. Full article

Background: Life satisfaction during the perinatal period has gained increasing attention as a relevant indicator of mental health, providing a more complete view of women’s adaptation to motherhood. Methods: This study examines the evolution of life satisfaction across four time points: the third trimester of pregnancy (T1), 8 weeks after birth (T2), 5 months after birth (T3) and 5 years postpartum (T4). A total of 231 women participated in this longitudinal study. Participants completed an ad hoc questionnaire for sociodemographic data and standardized self-report measures assessing different personality variables (attachment style, social support, maternal self-efficacy and positive/negative affect) at T1 as well as the Satisfaction with Life Scale (SWLS) (T1–T4). Statistical analyses were performed in order to evaluate the relationships between variables (Student’s test, ANOVA, Pearson’s correlation), and a linear regression analysis was conducted to explore the contribution of psychosocial variables at each time point. Additional subgroup analyses (employment status and parity) were carried out. Results: Results showed that at the first and second time points, life satisfaction was maintained, but five months after birth (T3), it decreased, and then it changed again five years after birth, increasing to its highest level. The psychosocial variables significantly associated with changes in life satisfaction varied across time points. Differential profiles are also observed depending on the subgroup. Conclusions: These findings suggest that monitoring these variables throughout the perinatal period may help identify women at risk and guide interventions in addition to preventive programs aimed at promoting well-being during the perinatal period and into motherhood. Full article

Objective: Multifetal gestations are linked to an increased risk of pregnancy-related hypertensive disorders and other adverse outcomes. The probability positively correlates with the number of fetuses. Therefore, the objective of the study was to assess the use of various maternal and pregnancy-related characteristics for the prediction of adverse pregnancy outcomes in triplet pregnancies, dependent on different possible predictive factors such as maternal age, BMI, assisted reproductive technology (ART), parity, uterine artery Doppler (UtA-PI) measured and chorionicity. Methods: This was a screening study in 99 triplet pregnancies to evaluate the risk for adverse pregnancy outcomes for PE, hypertension, fetal growth restriction (FGR), intrauterine fetal death (IUFD), small for gestational age (SGA) and preterm birth below 32 + 0 gestational weeks, dependent on different possible predictive factors. Logistic regression analysis was performed. Results: 99 triplet pregnancies were included. Additionally, 58 women (58.6%) developed adverse pregnancy outcomes: FGR 16.2%, SGA (3.0%). Gestational hypertension was observed in 16 pregnancies (16.2%), and preeclampsia was diagnosed in 11 cases (11.1%). Furthermore, 6 pregnancies (6.2%) were complicated by IUFD, and 36 pregnancies (36.4%) resulted in preterm birth before 32 + 0 weeks of gestation. Conclusions: Hypertension and PE are common maternal complications in triplet pregnancies. While higher maternal age is a clear predictor of hypertension and PE, a model based on maternal and pregnancy characteristics did not provide sufficient predictive accuracy. Full article