Document Detail

The effect of early fetal losses on twin assisted-conception pregnancy outcomes.
MedLine Citation:
PMID:  18804206     Owner:  NLM     Status:  MEDLINE    
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.
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    
Department of Obstetrics, Gynecology, and Reproductive Biology, Michigan State University, East Lansing, Michigan 48824, USA.
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MeSH Terms
Birth Weight
Cohort Studies
Fetal Death
Heart Rate, Fetal
Infant, Low Birth Weight
Infant, Newborn
Infant, Very Low Birth Weight
Maternal Age
Middle Aged
Odds Ratio
Pregnancy Outcome / psychology*
Pregnancy Trimester, First
Pregnancy Trimester, Third
Reference Values
Reproductive Techniques, Assisted / psychology*
Ultrasonography, Prenatal

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

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