oxidized LDL and formation of foamy macrophages present in the atherosclerotic plaque. We propose that scavenger receptors play a role in preterm labor, and therefore, designed a study to determine whether the expression of CD36 in trophoblasts, changes in cases of spontaneous preterm labor (with intact or rupture of membranes). STUDY DESIGN: A cross-sectional study was conducted to examine the histopathologic findings of the placenta of 96 patients, including term and preterm deliveries. The study groups included: 1) Normal deliv- eries at term (n=56), 2) Preterm labor with intact membranes (n=16), and 3) Preterm PROM (n=24). The percentage of CD36 immunoreactive villous trophoblasts was evaluated by two patholo- gists. RESULTS: 1) Immunoreactivity for CD36 was detected mainly in in- terstitial and villous trophoblasts, endothelium of the spiral arteries and fetal vessels; 2) CD36 immunoreactivity in villous trophoblasts was stronger in placentas of patients with preterm labor/delivery than in those from women who delivered at term (13.02 +/- 2.20 vs. 2.82 +/- 0.92, P  0.0001); 3) There was no significant difference in the mean percentage of CD36 positive trophoblasts between patients with preterm labor and intact membranes and preterm PROM. CONCLUSION: 1) A scavenger receptor for oxidized LDL, CD36 is ex- pressed in the human placenta; 2) The expression was greater (as determined by immunohistochemistry) in placentas of patients with preterm deliveries than in those who delivered at term. Our data sug- gest over-expression of CD36 in preterm labor and preterm PROM. 118 Comparing twin and triplet gestations: how much added risk with a third fetus? Heidi Leftwich 1 , Szilvia Kruss 2 , Judith Hibbard 2 1 University of Illinois, Maternal Fetal Medicine, Chicago, IL, 2 University of Illinois at Chicago, Obstetrics and Gynecology, Chicago, IL OBJECTIVE: The continued rise of multiple gestations is linked to the widespread use of assisted reproductive technologies (ART). The aim of this study is to quantify the added risk to mothers and neonates with triplet gestation versus twin gestation. STUDY DESIGN: Retrospective review of the electronic database created by the Consortium of Safe Labor, reflecting labor and delivery infor- mation from 12 clinical centers (19 hospitals) from 2002-2008. All twin and triplet gestations with complete data, liveborn infants and delivery greater than 24 weeks were included. Maternal morbidity was analyzed using univariate and multivariate analysis. Serious neonatal outcomes were compared via analysis of variance (ANOVA). Fetuses were matched by birth order for analysis. Significance was p.05. RESULTS: A total of 474 mothers with twins and 26 with triplets, and 948 twins and 78 triplets were reviewed. Univariate regression analysis showed statistically more chorioamnionitis (p=.011) in triplet moth- ers and more cases of abruption in twin mothers (p=.009); however on multivariate regression analysis, only chorioamnionitis was signif- icant (p=.018). All other maternal outcomes were not different. Comparing neonatal outcomes using ANOVA, severe neonatal out- comes were found to be statistically different (p.0001) when match- ing fetuses by birth order (See Table 1). When separating neonatal outcomes, the following were significant greater in the triplet cohort: neonatal ICU admission (p .05), respiratory distress syndrome (RDS), (p.01), sepsis (p.01), and congenital anomalies (p.05) (Figure 1). CONCLUSION: When controlling for birth order, there is a significant increase in neonatal sepsis, neonatal ICU admissions, congenital anomalies, and RDS in the triplet infants. Chorioamnionitis was the only significantly increased morbidity noted in mothers with higher order multiple gestations. Overall neonatal morbidity is significantly increased with triplet gestations. These results may assist clinicians in counseling ART gravidas carrying higher order multiple gestations. 119 Adverse perinatal outcomes in discordant twins with abnormal umbilical artery Doppler velocimetry Hilary Roeder 1 , Lynlee Wolfe 1 , Neha Trivedi 1 , Gladys Ramos 1 , Mana Parast 2 , Gina James 1 , Kurt Benirschke 2 , David Schrimmer 1 1 University of California San Diego, Department of Reproductive Medicine, San Diego, CA, 2 University of California San Diego, Department of Pathology, San Diego, CA OBJECTIVE: To examine discordant twins with abnormal umbilical ar- tery (UA) Doppler indices and determine if this finding is associated with adverse perinatal/neonatal outcomes. STUDY DESIGN: This retrospective cohort study identified 82 discor- dant twin pregnancies (20% weight difference) at our institution from 4/2003-6/2010. These gestations were divided into two groups: those with normal (group 1) and abnormal (group 2) UA Doppler indices. Data abstracted included maternal demographics, chorionic- ity, placental cord insertion site (PCI), and severity of discordance. Outcomes included gestational age (GA) at delivery, time interval from diagnosis of discordance to delivery, birthweight (BW), BW per- centile, neonatal or fetal demise, length of stay (LOS) in the neonatal intensive care unit (NICU), 5-minute APGAR scores 7, and com- posite neonatal morbidity (RDS, IVH, ROP, NEC). Bivariate and re- gression analysis were performed. RESULTS: A total of 157 infants resulting from 82 discordant twin ges- tations were analyzed. There were 47 (57%) pregnancies in group 1 and 35 (43%) in group 2. Maternal age and chorionicity did not differ between groups. PCI was abnormal more often in group 2 than group 1 (27% vs. 49%, p=0.009) as was the percentage of discordance (23% vs. 33%, p0.001). Twins in group 2 compared with group 1 delivered at an earlier GA (32 vs. 35 wks, p0.001). Controlling for GA at diagnosis, there was no difference between the time interval from diagnosis of discordance to delivery. Group 2 had a lower BW (1513 vs. 2300 grams, p0.001), BW percentile (8.5 versus 16.5, p0.001), and higher NICU LOS (22 vs. 6 days, p0.001). There were no dif- www.AJOG.org Clinical Obstetrics, Medical-Surgical-Disease, Neonatology, Physiology-Endocrinology Poster Session I Supplement to JANUARY 2012 American Journal of Obstetrics & Gynecology S65