Perinatal and neonatal outcomes in multiple gestations: Assisted reproduction versus spontaneous conception

Fitzsimmons, Brian; Bebbington, Michael; Fluker, Margo R.

doi:10.1016/s0002-9378(98)70125-5

Cited by 117 publications

(73 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In agreement with the results of this study, Fitzsimmons et al 8 found no difference in mean birthweights and gestational age at delivery among multiple births resulting from assisted reproductive therapy (assisted reproductive technology or clomiphene citrate) and spontaneously conceived multiple birth controls. This group of Canadian researchers did, however, report an increase in perinatal mortality among spontaneously conceived twins 8 .…”

Section: Discussionsupporting

confidence: 92%

See 1 more Smart Citation

The contribution of assisted conception, chorionicity and other risk factors to very low birthweight in a twin cohort

Lynch

2003

BJOG: An International Journal of Obstetrics and Gynaecology

View full text Add to dashboard Cite

Objectives To investigate the contribution of assisted conception (assisted reproductive technology and ovulation induction), chorionicity and selected maternal risk factors for very low birthweight. Design Retrospective twin cohort study.Setting Staff model Colorado Health Maintenance Organization.Sample Five hundred and sixty-two twin gestations [assisted ¼ 193 (34%); unassisted ¼ 369 (66%)].Methods Data were collected from a perinatal database and medical record review. Data were analysed using univariate and multivariable logistic regression analysis. Main outcome measure Very low birthweight.Results Women with assisted twin gestation were more likely to be older, nulliparous, non-smokers, married, have a prior history of a miscarriage and a dichorionic placentation. There was no difference in the distribution of low and very low birthweight, discordant growth or preterm delivery between assisted and unassisted twin gestations. Significant risk factors for very low birthweight were: a prior preterm birth (odds ratio, OR, 3.8, 95% confidence interval, CI, 2, 7), monochorionicity (OR 3, 95% CI 2, 4.7), nulliparity (OR 2, 95% CI 1.3, 3), cigarette smoking (OR 1.8, 95% CI 1, 3) and prior miscarriage (OR 1.6, 95% CI 1, 2). Monochorionicity was significantly associated with adverse perinatal outcomes. Conclusion Assisted conception did not play a significant role in the occurrence of very low birthweight in this cohort. A history of preterm birth and a monochorionic twin gestation were the leading risk factors for very low birthweight. Associated risk factors for very low birthweight were nulliparity, cigarette smoking and a prior miscarriage.

show abstract

Section: Discussionsupporting

confidence: 92%

“…This group of Canadian researchers did, however, report an increase in perinatal mortality among spontaneously conceived twins 8 . Agustsson et al 4 studied 69 assisted twin pregnancies and 453 natural conceptions from Iceland and Scotland.…”

Section: Discussionmentioning

confidence: 91%

The contribution of assisted conception, chorionicity and other risk factors to very low birthweight in a twin cohort

Lynch

2003

BJOG: An International Journal of Obstetrics and Gynaecology

View full text Add to dashboard Cite

show abstract

“…This study included more mature infants, however, with a mean birth weight of 1600 g in triplets and 2320 g in twins. Other studies [10][11][12][13][14][15] have evaluated outcomes of triplet or highergestation infants in comparison to twins, but they had small sample sizes and none of them had evaluated ELBW infants exclusively. Russell et al, 5 using National Center for Health Statistics data, showed that the mortality rate for very low birth weight and moderately low birth weight multiplegestation infants was lower than for singletons in similar birth-weight categories.…”

Section: Discussionmentioning

confidence: 99%

Neurodevelopmental Outcomes of Triplets or Higher-Order Extremely Low Birth Weight Infants

Wadhawan

Vohr

et al. 2011

Pediatrics

View full text Add to dashboard Cite

BACKGROUND: Extremely low birth weight twins have a higher rate of death or neurodevelopmental impairment than singletons. Higher-order extremely low birth weight multiple births may have an even higher rate of death or neurodevelopmental impairment. METHODS: Extremely low birth weight (birth weight 401–1000 g) multiple births born in participating centers of the Neonatal Research Network between 1996 and 2005 were assessed for death or neurodevelopmental impairment at 18 to 22 months' corrected age. Neurodevelopmental impairment was defined by the presence of 1 or more of the following: moderate to severe cerebral palsy; mental developmental index score or psychomotor developmental index score less than 70; severe bilateral deafness; or blindness. Infants who died within 12 hours of birth were excluded. Maternal and infant demographic and clinical variables were compared among singleton, twin, and triplet or higher-order infants. Logistic regression analysis was performed to establish the association between singletons, twins, and triplet or higher-order multiples and death or neurodevelopmental impairment, controlling for confounding variables that may affect death or neurodevelopmental impairment. RESULTS: Our cohort consisted of 8296 singleton, 2164 twin, and 521 triplet or higher-order infants. The risk of death or neurodevelopmental impairment was increased in triplets or higher-order multiples when compared with singletons (adjusted odds ratio: 1.7 [95% confidence interval: 1.29–2.24]), and there was a trend toward an increased risk when compared with twins (adjusted odds ratio: 1.27 [95% confidence: 0.95–1.71]). CONCLUSIONS: Triplet or higher-order births are associated with an increased risk of death or neurodevelopmental impairment at 18 to 22 months' corrected age when compared with extremely low birth weight singleton infants, and there was a trend toward an increased risk when compared with twins.

show abstract

“…In another study, controls, but not cases, included several twin to twin transfusions in babies referred for special care. 16 Similar degrees of arbitrariness may have applied to other matched cohort studies without being apparent from the data.…”

Section: Bias and Confoundingmentioning

confidence: 94%

“…16 However, most twin studies showed a lower mortality after assisted than after natural conception, with a relative risk of 0.58 (0.44 to 0.77) for matched and 0.84 (0.53 to 1.32) for non-matched studies (table 4).…”

Section: Nicu Admissionsmentioning

confidence: 99%

Perinatal outcome of singletons and twins after assisted conception: a systematic review of controlled studies

2004

Obstetrics & Gynecology

View full text Add to dashboard Cite

show abstract

Perinatal and neonatal outcomes in multiple gestations: Assisted reproduction versus spontaneous conception

Cited by 117 publications

References 10 publications

The contribution of assisted conception, chorionicity and other risk factors to very low birthweight in a twin cohort

The contribution of assisted conception, chorionicity and other risk factors to very low birthweight in a twin cohort

Neurodevelopmental Outcomes of Triplets or Higher-Order Extremely Low Birth Weight Infants

Perinatal outcome of singletons and twins after assisted conception: a systematic review of controlled studies

Contact Info

Product

Resources

About