Multiple Gestations and Assisted Reproductive Technology

Broughton, Darcy E.; Jungheim, Emily S.

doi:10.1016/b978-0-323-40139-5.00007-3

Cited by 3 publications

(4 citation statements)

References 138 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Multiple pregnancies account for a small percentage of overall live births, but their rate has increased by 76% in the past three decades in industrialized nations because of increased utilization of ART and an increased risk of spontaneous twinning in women delaying childbearing. [5] Multiple pregnancies compared to singleton pregnancies are at higher risk of preeclampsia and other hypertensive disorders, placental abruption, postpartum hemorrhage, venous thromboembolism, and hypertensive disorders, which increase significantly maternal morbid-ity and mortality. The multiple pregnancies in a large percentage of cases end with premature birth.…”

Section: Discussionmentioning

confidence: 99%

“…Monochorionic monoamniotic (MCMA) twins are at greater risk for these complications than monochorionic diamniotic multiples, but MCMA multiples also frequently face growth discordance IUGR and cord entanglement. [5,7,8] Prematurity is the main reason for higher morbidity and mortality of the twins compared to the singletons -a fivefold increased risk of stillbirth and a sevenfold increased risk of neonatal death. [9] According to our data, the insufficient prenatal steroid prophylaxis, higher rate of intrauterine hypotrophy and severe intrapartum asphyxia aggravate the morbidity of these patients.…”

Section: Discussionmentioning

confidence: 99%

“…The Higher fetal number correlates with increased risk of IUGR, earlier delivery, prolonged hospital stay, major handicap and cerebral palsy, and death in the first postnatal year. [5] Divergence from singleton growth curves occurs at approximately 32-33 weeks in twin gestations, at 29-30 weeks in triplet gestations, and at 27-28 weeks in quadruplet gestations. Blickstein et al have evaluated the neonatal mortality rate among discordant twins classified according to the birth weight of the smaller twin.…”

Section: Discussionmentioning

confidence: 99%

“…ART multiples suffer additionally from birthweight discordance. [5] ART has been reported to affect mortality and perinatal outcomes in extremely low gestational age infants. [16,17] Twins born as a result of ART have been reported to have a lower risk of perinatal death compared with naturally conceived twins.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Impact of Multiple Births on the Outcome in Extremely Low Birth Weight Newborns

Atanasova¹,

Ivanov²,

Gyokova³

et al. 2021

JofIMAB

View full text Add to dashboard Cite

Objective: To evaluate the outcome of the extremely low birth weight newborns (ELBWNs) from single and twin pregnancies. Material and methods: The study lasts from 2005 to 2017 and includes all life born ELBWNs treated in University Hospital, Pleven, Bulgaria. Patients' groups: singletons (1) and twins (2); twins conceived naturally(2.1) and after assisted reproductive technologies – ART(2.2). Results: One hundred and eighty two (182) ELBWNs are examined, 65 (35.7%) of them are twins. The twins, compared to singletons, are significantly more often conceived by ART (47.7 vs 4.3%, p<0.001) and significantly more rarely infected prenatally (18 vs 41%, p 0.002). The survival rate is 51.3% for singletons and 56.6% for twins, NS. Survived twins (n 37) achieve later their optimal nutritive tolerance (30±11 vs 25±10 days, p 0.046), require more blood transfusions (3.6±1.9 vs 2.6±1.8 per patient, p 0.009) and longer mechanical ventilation (16±15 vs 9±12 days, p 0.03) than survival singletons (n 60). The twins suffer more often from intraventricular haemorrhage (46 vs 18%, p 0.004), patent ductus arteriosus (35 vs 15%, p 0.02) and long-term complications (51 vs 30%, p 0.04) than singletons. ART-twins (n 31)compared to the subgroup 2.1 (n 34) are more frequently intubated in the delivery room (81 vs. 50%, p 0.01)but suffer less frequently from nosocomial infections (53 vs. 85%, p 0.03). Conclusions: According to our data, ELBW-twins frequently suffer from respiratory, haemorrhagic, and gastrointestinal problems than ELBW-singletons, resulting in more long-term complications. Our study proves that ART does not influence the outcome in multiples.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Impact of Multiple Births on the Outcome in Extremely Low Birth Weight Newborns

Atanasova¹,

Ivanov²,

Gyokova³

et al. 2021

JofIMAB

View full text Add to dashboard Cite

show abstract

Association Between Assisted Reproductive Technology and Cerebral Palsy: A Meta-Analysis

Cavero-Ibiricu,

Canelas-Fernández,

Gómez-Acebo

et al. 2024

Pediatric Neurology

View full text Add to dashboard Cite

Risk of neurodevelopmental disorders in children born from different ART treatments: a systematic review and meta-analysis

Djuwantono

Aviani²,

Permadi

et al. 2020

J Neurodevelop Disord

View full text Add to dashboard Cite

Background Various techniques in assisted reproductive technology (ART) have been developed as solutions for specific infertility problems. It is important to gain consensual conclusions on the actual risks of neurodevelopmental disorders among children who are born from ART. This study aimed to quantify the relative risks of cerebral palsy, intellectual disability, autism spectrum disorder (ASD), and behavioral problems in children from different ART methods by using systematic review and meta-analysis. Healthcare providers could use the results of this study to suggest the suitable ART technique and plan optimum postnatal care. Methods Pubmed, Google Scholar, and Scopus databases were used to search for studies up to January 2020. Of the 181 screened full manuscripts, 17 studies (9.39%) fulfilled the selection criteria. Based on the Newcastle-Ottawa scale ratings, 7 studies were excluded, resulting in 10 studies that were eventually included in the meta-analyses. Mantel-Haenszel risk ratio model was used in the meta-analysis, and the results are described using forest plot with 95% confidence interval. Heterogeneity was assessed using the I2 value. Results Pooled evaluation of 10 studies showed that the risk of cerebral palsy in children from assisted reproductive technology (ART) is higher than children from natural conceptions (risk ratio [RR] 1.82, [1.41, 2.34]; P = 0.00001). Risk of intellectual disability (RR 1.46, [1.03, 2.08]; P = 0.03) and ASD (RR 1.49 [1.05, 2.11]; P = 0.03) are higher in intracytoplasmic sperm injection (ICSI) children compared to conventional in vitro fertilization (IVF) children. The differences in the risk of neurodevelopmental disorders in children born after frozen and fresh embryo transfers are not significant. Analysis on potential cofounder effects, including multiple birth, preterm birth, and low birth body weight highlight possibilities of significant correlation to the risks of neurodevelopmental disorders. Conclusions Pooled estimates suggest that children born after ART are at higher risk of acquiring cerebral palsy. ICSI treatment causes higher risk of intellectual disability and ASD. These findings suggest the importance of the availability of intensive care unit at the time of delivery and long-term developmental evaluation particularly in children from ICSI.

show abstract

Multiple Gestations and Assisted Reproductive Technology

Cited by 3 publications

References 138 publications

Impact of Multiple Births on the Outcome in Extremely Low Birth Weight Newborns

Impact of Multiple Births on the Outcome in Extremely Low Birth Weight Newborns

Association Between Assisted Reproductive Technology and Cerebral Palsy: A Meta-Analysis

Risk of neurodevelopmental disorders in children born from different ART treatments: a systematic review and meta-analysis

Contact Info

Product

Resources

About