Degree and Rate of Growth Discordance in Dichorionic Twins Conceived by In Vitro Fertilization

Egić, Amira; Mojovic, Donka; Milovanovic, Zagorka; Jurisic, A.; Srbinović, L; Krsmanović, Suzana; Karadžov-Orlić, Nataša

doi:10.1155/2014/543728

Cited by 9 publications

(10 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The computation of the strength of association between BW discordance ≥30% and morbidity was affected by the inclusion of only two studies (2660 twins) (Figure ) . Overall, twins with BW discordance ≥30% were at higher risk of composite morbidity compared with controls (OR 3.4, 95% CI 2.2‐3.2; I 2 = 0%, P < 0.001) and this association persisted in DC (OR 3.6, 95% CI 2.3‐5.7; I 2 = 0%, P < 0.001) but not in MC ( P = 0.9) twins (Table ).…”

Section: Resultsmentioning

confidence: 99%

“…In all, 3594 articles were identified; of these, 208 were assessed with respect to their eligibility for inclusion (Supporting Information Appendices S1 and S2) and 25 studies were included in the systematic review ( Table 1, Supporting Information Table S1). [9][10][11][12][13][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] Among them, 22 studies (including 11 470 twin pregnancies) reported the occurrence of morbidity in twins affected compared with those not affected by BW discordance, and three exclusively reported on the occurrence of morbidity in the smaller compared with larger twin. 30,32,39 The prevalence of ≥15%, 20%, 25% and 30% BW discordance was 25 14.5% (95% CI 11.5-18.5) and 2.8% (95% CI 0.9-6.4).…”

Section: General Characteristicsmentioning

confidence: 99%

See 1 more Smart Citation

Birthweight discordance and neonatal morbidity in twin pregnancies: A systematic review and meta‐analysis

Mascio

Acharya

Khalil

et al. 2019

Acta Obstet Gynecol Scand

View full text Add to dashboard Cite

Introduction The aim of this systematic review was to quantify the association between birthweight discordance and neonatal morbidity in twin pregnancies. Material and methods MEDLINE, Embase and Cinahl databases were searched. Studies reporting the occurrence of morbidity in twins affected compared with those not affected by birthweight discordance were included. The primary outcome was composite neonatal morbidity (including neurological, respiratory, infectious morbidities, abnormal acid‐base status and necrotizing enterocolitis). The secondary outcomes were the individual morbidities. Sub‐group analysis according to chorionicity, gestational age at birth and fetal weight (smaller vs larger twin) was also performed. Random‐effect head‐to‐head meta‐analyses were used to analyze the data. Results Twenty studies (10 851 twin pregnancies) were included. The risk of composite morbidity was significantly higher in the pregnancies with birthweight discordance ≥15% (odds ratio [OR] 1.4, 95% confidence interval [CI] 1.0‐1.9), ≥20% (OR 2.2, 95% CI 1.40‐3.45), ≥25% (OR 2.5, 95% CI 1.8‐3.6), and ≥30% (OR 3.4, 95% CI 2.2‐3.2). In dichorionic twins, birthweight discordance ≥15% (OR 2.4, 95% CI 1.65‐3.46), ≥20% (OR 2.2, 95% CI 1.3‐3.8), ≥25% (OR 2.7, 95% CI 1.4‐5.1) and ≥30% (OR 3.6, 95% CI 2.3‐5.7) were all significantly associated with composite neonatal morbidity. Analysis of monochorionic twins was hampered by the very small number of included studies, which precluded adequate statistical power. Monochorionic twins with a birthweight discordance ≥20% were at significantly higher risk of composite neonatal morbidity (OR 2.2, 95% CI 1.1‐4.9) compared with those presenting with lesser degree of discordance. When stratifying the analysis according to gestational age at birth and fetal size, twins with birthweight discordance ≥15%, 20%, 25% and 30% delivered at ≥34 weeks were at higher risk of neonatal morbidity compared with controls, but there was no difference in the risk of morbidity between the larger and the smaller twin in the discordant pair. Conclusions Birthweight discordance is associated with neonatal morbidity in twin pregnancies. The strength of this association persists for dichorionic twins. It was not possible to extrapolate robust evidence on monochorionic twins due to the low power of the analysis due to the small number of included studies.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: General Characteristicsmentioning

confidence: 99%

Birthweight discordance and neonatal morbidity in twin pregnancies: A systematic review and meta‐analysis

Mascio

Acharya

Khalil

et al. 2019

Acta Obstet Gynecol Scand

View full text Add to dashboard Cite

show abstract

“…1,[9][10][11][12][13][14] A majority of studies reported that ART twin pregnancies had obstetric outcomes comparable to SC twin pregnancies. 1,9,10,[14][15][16][17][18] Several studies found higher risks of adverse perinatal outcomes among ART-related twin pregnancies, [19][20][21][22] whereas others reported reduced adverse outcomes among iatrogenic twin pregnancies. 12,23 Therefore, it is not yet clear whether ART-related twins have higher risks than spontaneous conceived twins and of what magnitude these risks are.…”

Section: Introductionmentioning

confidence: 99%

“…Although some reports find poorer outcomes among those singletons resulting from infertility treatments compared with spontaneously conceived (SC) ones, 6‐8 findings among twin gestations are inconsistent 1,9‐14 . A majority of studies reported that ART twin pregnancies had obstetric outcomes comparable to SC twin pregnancies 1,9,10,14‐18 . Several studies found higher risks of adverse perinatal outcomes among ART‐related twin pregnancies, 19‐22 whereas others reported reduced adverse outcomes among iatrogenic twin pregnancies 12,23 .…”

Section: Introductionmentioning

confidence: 99%

Association between IVF/ICSI treatment and preterm birth and major perinatal outcomes among dichorionic‐diamnionic twin pregnancies: A seven‐year retrospective cohort study

Lin

Fan

et al. 2020

Acta Obstet Gynecol Scand

View full text Add to dashboard Cite

Introduction This study aimed to evaluate the preterm birth and additional perinatal outcomes between spontaneous and in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) dichorionic‐diamnionic (DCDA) twin pregnancies. Material and methods This retrospective cohort study was conducted in a tertiary university‐affiliated medical center. All women with DCDA twin pregnancies were considered for inclusion. The primary outcome of interest was preterm birth <37 weeks of gestation and secondary outcomes included spontaneous preterm birth, iatrogenic (induced) preterm birth, gestational diabetes mellitus, pregnancy‐induced hypertensive disorder, preeclampsia, preterm premature rupture of membranes (PPROM), intrahepatic cholestasis of pregnancy, placenta previa, neonatal intensive care unit (NICU) admission, birthweight discordance, small for gestational age, neonatal respiratory distress syndrome, ventilator support, and perinatal death and/or severe morbidity. These outcomes were compared between IVF/ICSI and spontaneous twin pregnancies. Multivariable logistic regressions were used to adjust for confounders. General estimated equation models were used to address intertwin correlation. Results A total of 1297 twin pregnancies, including 213 spontaneous and 1084 IVF/ICSI DCDA pregnancies, met the inclusion criteria. Women with IVF/ICSI pregnancies were older and had higher body mass index, adherence with prenatal care and proportion of nulliparity. After adjustment for confounders, IVF/ICSI pregnancies were associated with a slight increase in preterm birth <37 weeks of gestation (adjusted odds ratio [aOR] 1.72; 95% CI 1.24‐2.39), iatrogenic preterm birth <37 weeks of gestation (aOR 1.41; 95% CI 1.00‐1.97) as well as NICU admission (aOR 1.34; 95% CI 1.00‐1.80). IVF/ICSI pregnancies were associated with a decrease in PPROM (aOR 0.64; 95% CI 0.42‐0.99). There were no differences between IVF/ICSI and spontaneous DCDA pregnancies in terms of spontaneous preterm birth, gestational diabetes mellitus, pregnancy‐induced hypertensive disorder, preeclampsia, intrahepatic cholestasis of pregnancy, placenta previa, birthweight discordance, small for gestational age, neonatal respiratory distress syndrome, ventilator support, and perinatal death and/or severe morbidity. Conclusions IVF/ICSI DCDA twin pregnancies were associated with a slight increase in preterm birth <37 weeks of gestation, iatrogenic preterm birth <37 weeks of gestation, and NICU admission but with a decrease in PPROM. Other outcomes were comparable between IVF/ICSI and spontaneous DCDA twin pregnancies. Multicenter studies with adequate power remain warranted.

show abstract

“…These studies may misrepresent the infertile population, and the conclusions may be less generalizable. In addition, conflicting results may be from studies only adjusting for some confounding variables or none at all [9,10,22,23].…”

Section: Introductionmentioning

confidence: 99%

Neonatal outcomes among twins stratified by method of conception: secondary analysis of maternal fetal medicine (MFMU) network database

Shah

Nasab

Chappell

et al. 2018

J Assist Reprod Genet

View full text Add to dashboard Cite

show abstract

Degree and Rate of Growth Discordance in Dichorionic Twins Conceived by In Vitro Fertilization

Cited by 9 publications

References 16 publications

Birthweight discordance and neonatal morbidity in twin pregnancies: A systematic review and meta‐analysis

Birthweight discordance and neonatal morbidity in twin pregnancies: A systematic review and meta‐analysis

Association between IVF/ICSI treatment and preterm birth and major perinatal outcomes among dichorionic‐diamnionic twin pregnancies: A seven‐year retrospective cohort study

Neonatal outcomes among twins stratified by method of conception: secondary analysis of maternal fetal medicine (MFMU) network database

Contact Info

Product

Resources

About