Document Detail


The effect of early fetal losses on twin assisted-conception pregnancy outcomes.
MedLine Citation:
PMID:  18804206     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the effect of first trimester fetal losses on twin births from assisted reproductive technology (ART). DESIGN: Historical cohort study. SETTING: Clinic-based data. PATIENT(S): The study population included 9,036 twin pregnancies of >or=22 weeks' gestation in the 2005 Society for Assisted Reproductive Technology Clinic Outcomes Reporting System database, categorized by the presence of three versus two fetal heartbeats on early ultrasound. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Length of gestation and birthweight. Adjusted odds ratios (AORs) were calculated with the group with two fetal heartbeats on early ultrasound as the reference. RESULT(S): Increased odds with three fetal heartbeats included <32 weeks, 32-36 weeks, and <37 weeks (AORs 1.47, 1.28, and 1.35, respectively) and very low birthweight (<1,500 g), moderately low birthweight (1,500-2,499 g), and low birthweight (<2,500 g) (AORs 1.69, 1.38, and 1.47, respectively). Significantly decreased odds included term birth (>or=37 weeks) and nonlow birthweight (>or=2,500 g) (AORs 0.74 and 0.68). CONCLUSION(S): Early fetal loss in assisted-conception pregnancies that result in a twin live birth is associated with significantly increased risks for lowered birthweight and shortened gestation. Because first-trimester multiple fetal heartbeats are more common in ART pregnancies, this factor may help explain the greater risk for reduced birthweight and shorter gestations observed in this population.
Authors:
Barbara Luke; Morton B Brown; David A Grainger; Judy E Stern; Nancy Klein; Marcelle I Cedars
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-09-18
Journal Detail:
Title:  Fertility and sterility     Volume:  91     ISSN:  1556-5653     ISO Abbreviation:  Fertil. Steril.     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-06-01     Completed Date:  2009-07-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372772     Medline TA:  Fertil Steril     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2586-92     Citation Subset:  IM    
Affiliation:
Department of Obstetrics, Gynecology, and Reproductive Biology, Michigan State University, East Lansing, Michigan 48824, USA. lukeb@msu.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Birth Weight
Cohort Studies
Female
Fetal Death
Heart Rate, Fetal
Humans
Infant, Low Birth Weight
Infant, Newborn
Infant, Very Low Birth Weight
Maternal Age
Middle Aged
Odds Ratio
Pregnancy
Pregnancy Outcome / psychology*
Pregnancy Trimester, First
Pregnancy Trimester, Third
Reference Values
Reproductive Techniques, Assisted / psychology*
Twins
Ultrasonography, Prenatal

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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