Developmental outcome of very low birth weight twins conceived by assisted reproduction techniques

Ito, Aya; Honma, Yoko; Inamori, E; Yada, Yukari; Momoi, Mariko Y.; Nakamura, Yosikazu

doi:10.1038/sj.jp.7211433

Cited by 9 publications

(8 citation statements)

References 14 publications

(12 reference statements)

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“…Limitations within this study are that it did not describe the outcomes of full multiple sets, only the siblings within a multiple set if they met they met the criteria of having a birthweight of 1250 g. Birth order, growth discordance, chorionicity and in utero demise or fetal reduction were not assessed as potential determinants of outcome, although these factors can affect immediate perinatal outcomes [29][30][31][32][33][34] and even later neuromorbidity. 35 Some studies suggest a negative impact of ART on developmental outcomes, [36][37][38] but in our study the type of ART was not identified or linked to the individual cases and outcomes.…”

Section: Discussioncontrasting

confidence: 64%

Triplet Infants with Birthweight ≤ 1250 Grams: How Well Do They Compare with Twin and Singleton Infants at 36 to 48 Months of Age?

et al. 2008

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The purpose of this study was to determine if triplet infants with birthweight < or = 1250 g were at increased risk of long-term disability compared with similar birthweight and gestational age singletons and twins. This was a retrospective cohort study of < or = 1250-g infants admitted to a regional neonatal intensive care unit from 1986 to 2001 with follow-up to 36 to 48 months corrected gestational age. Outcomes studied were cognitive ability, cerebral palsy, and neurosensory impairment at 36 to 48 months. Enrollment was 1717 infants: 59 triplets, 402 twins, and 1256 singletons. Triplet infants differed from twin or singleton infants because they were more likely to have older, married mothers (relative risk [RR] 3.62, 95% CI 1.31, 5.94), be products of assisted reproductive technology pregnancies (RR 29.59, 95% CI 13.97, 62.68), be exposed to antenatal steroids (RR 1.55, 95% CI 1.38, 1.75), and were all delivered by cesarean section. Triplet infants had lower risk of having intraventricular hemorrhage (RR 0.19, 95% CI 0.05, 0.75). The risk of cerebral palsy, cognitive delay, total major disability, or chronic lung disease was similar in triplet and twin infants compared with singleton infants. The lower risk of having intraventricular hemorrhage in triplet infants may have been due to the use of antenatal corticosteroids and cesarean section delivery.

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Section: Discussioncontrasting

confidence: 64%

Triplet Infants with Birthweight ≤ 1250 Grams: How Well Do They Compare with Twin and Singleton Infants at 36 to 48 Months of Age?

et al. 2008

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“…In one study the children identified with CP or other adverse outcomes were excluded before further examination. 44 Fourteen studies assessed motor development, [43][44][45][46][47][48][49][50][51][52][53][54][55][56] and 2 reported that children born as a result of ICSI (ICSI children) had a statistically significant higher risk of delayed motor development at 1 to 2 or 5 years of age, respectively. 44,57 Eleven studies assessed behavioral development 33,44,46,56,[58][59][60][61][62][63][64] ; 2 reported a statistically significant higher risk of delayed behavioral development in ICSI children aged 1 to 2 years 44 and IVF children aged 9 to 10 years, 58 respectively.…”

Section: Resultsmentioning

confidence: 99%

“…The large population-based register study found an increased risk of behavioral problems in children born after IVF (OR, 1.74; 95% CI, 1.11-2.74). 33 Nine studies assessed delay in cognitive development 43,45,51,54,[56][57][58]65,66 and 1 study reported that ICSI children had a statistically significant lower risk of delayed cognitive development at 8 years of age, while another study reported that ICSI children had a statistically significant higher risk of delayed cognitive development at 5 to 8 years of age. 65 Eleven studies assessed delay in mental development, 44,[46][47][48][49][50]52,[67][68][69][70][71] and 1 found less adverse outcomes in twins born as a result of assisted conception 71 while all other studies on developmental delay described non-statistically significant findings.…”

Section: Resultsmentioning

confidence: 99%

Cerebral Palsy, Autism Spectrum Disorders, and Developmental Delay in Children Born After Assisted Conception

Hvidtjørn¹,

Schieve²,

Schendel³

et al. 2009

Arch Pediatr Adolesc Med

137

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To assess the existing evidence of associations between assisted conception and cerebral palsy (CP), autism spectrum disorders (ASD), and developmental delay. Data Sources: Forty-one studies identified in a systematical PubMed and Excerpta Medica Database (EMBASE) search for articles published from January 1, 1996, to April 1, 2008. Study Selection: Studies written in English comparing children born after assisted conception with children born after natural conception assessing CP, ASD, and developmental delay, based on original data with a follow-up of 1 year or more. Main Exposures: In vitro fertilization (IVF) with or without intracytoplasmic sperm injection or ovulation induction with or without subsequent intrauterine insemination. Main Outcome Measures: Cerebral palsy, ASD, and developmental delay. Results: Nine CP studies showed that children born after IVF had an increased risk of CP associated with preterm delivery. In our meta-analysis including 19 462 children exposed to IVF, we estimated a crude odds ratio of 2.18 (95% confidence interval, 1.71-2.77). Eight ASD studies and 30 studies on developmental delay showed inconsistent results. No studies assessed the risk of CP, ASD, or developmental delay in children born after ovulation induction exclusively.

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“…While some studies have shown a higher incidence of neuro-developmental impairment in twins conceived by ART as compared to naturally conceived twins (24), others have shown the opposite to be true (25). There was no data available on the acuity of illness of these infants that may have had an impact on their long-term outcomes.…”

Section: Discussionmentioning

confidence: 99%

Twin Gestation and Neurodevelopmental Outcome in Extremely Low Birth Weight Infants

Wadhawan

Perritt

et al. 2009

Pediatrics

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Objective To compare the risk-adjusted incidence of death or neuro-developmental impairment at 18–22 months corrected age, between twin and singleton extremely low birth weight infants. Hypothesis Twin gestation is independently associated with increased risk of death or adverse neuro-developmental outcomes at 18–22 months corrected age in extremely low birth weight infants. Design/Methods Retrospective study of inborn extremely low birth weight infants (BW 401– 1000g) admitted to NICHD Neonatal Research Network units between 1997 and 2005, who either died or had follow-up data available at 18–22 months corrected age. Neuro-developmental impairment (NDI), the primary outcome variable, was defined as the presence of any one of the following: moderate or severe cerebral palsy, severe bilateral hearing loss needing amplification, bilateral blindness, Bayley Mental Developmental Index or Psychomotor Developmental Index of less than 70. Death was included with NDI as a composite outcome since it is a competing variable. Results were compared for both twins, twin A, twin B, same sex twins, unlike sex twins and singleton infants. Logistic regression analysis was done to control for demographic and clinical factors that were different among the groups. Results The cohort of infants who either died or were assessed for NDI consisted of 7,630 singleton infants and 1,376 twins. Logistic regression adjusting for clinical and socio-demographic risk factors showed an increased risk of death or NDI for twins as a group when compared with the singletons (OR-1.39, 95% CI- 1.19–1.63). On analyzing twin A and B separately as well, risk of death or NDI was increased in both twin A (OR-1.32, 95% CI- 1.09–1.59) and for twin B (OR-1.47, 95% CI- 1.21–1.78), when compared with singleton infants. Conclusions Twin gestation in ELBW infants is associated with an independent increased risk of death or NDI at 18–22 months corrected age, compared to ELBW singleton gestation infants. Both first and second born twins are at increased risk of death or NDI when compared to singleton ELBW infants.

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Developmental outcome of very low birth weight twins conceived by assisted reproduction techniques

Cited by 9 publications

References 14 publications

Triplet Infants with Birthweight ≤ 1250 Grams: How Well Do They Compare with Twin and Singleton Infants at 36 to 48 Months of Age?

Triplet Infants with Birthweight ≤ 1250 Grams: How Well Do They Compare with Twin and Singleton Infants at 36 to 48 Months of Age?

Cerebral Palsy, Autism Spectrum Disorders, and Developmental Delay in Children Born After Assisted Conception

Twin Gestation and Neurodevelopmental Outcome in Extremely Low Birth Weight Infants

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