Birth Weight Discordance in Spontaneous Versus Induced Twins: Impact on Perinatal Outcome

Zádori, János; Kozinszky, Zoltán; Orvos, Hajnalka; Katona, Márta; Kaali, Steven G.; Pál, Attila

doi:10.1023/b:jarg.0000027019.87795.4e

Cited by 20 publications

(14 citation statements)

References 13 publications

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“…Regarding delivery, the induced group had higher rates of caesareans, as described in other studies 21,28 . We found that all the results were independent of chorionicity and the induced method chosen.…”

Section: Discussionsupporting

confidence: 80%

“…This seems to be due to an increase in the age of reproduction, the use of OI and the use of IVF 19 . Studies have shown that singleton pregnancies that are the product of IVF are at an increased risk of preterm delivery, low birth weight, induction of labor, cesarean delivery and pregnancy-induced hypertension compared with SC singleton pregnancies 20,21 . However, studies that have compared IVF with SC twin pregnancies have yielded conflicting results.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Do induced twin pregnancies influence the obstetric and neonatal results of multiple births born before 32 weeks? Comparison to spontaneous gestation

Dinis¹,

Domingues²,

Belo³

et al. 2015

Rev. Bras. Ginecol. Obstet.

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PURPOSE: To compare obstetric outcomes of induced preterm twin births (under 32 weeks gestation) with those spontaneously conceived. METHODS: Prospective study of twin pregnancies (25 induced and 157 spontaneously conceived) developed over a period of 16 years in a tertiary obstetric center. Demographic factors, obstetric complications, gestational age at delivery, mode of delivery, birth weight and immediate newborn outcome were compared. RESULTS: The analysis of obstetrical complications concerning urinary or other infections, hypertensive disorders of pregnancy, gestational diabetes, fetal malformations, intrauterine fetal death, intrauterine growth restriction and intrauterine discordant growth reveal no significant statistical differences between the two groups. First trimester bleeding was higher in the induced group (24 versus 8.3%, p=0.029). The cesarean delivery rate was 52.2% in spontaneous gestations and 64% in induced gestations. Gestational age at delivery, birth weight, Apgar scores at first and fifth minutes, admissions to Neonatal Intensive Care Unit and puerperal complications show no statistically significant differences between the two groups. These results were independent of chorionicity and induction method. CONCLUSION: The mode of conception did not influence obstetric and neonatal outcomes. Although induced pregnancies have higher risk of first trimester bleeding, significant differences were not observed regarding other obstetric and puerperal complications and neonatal results. ResumoOBJETIVO: Comparar os resultados obstétricos de gestações gemelares induzidas com as concebidas espontaneamente, em partos ocorridos antes da 32ª semana de idade gestacional. MÉTODOS: Estudo prospectivo de gestações gemelares (25 induzidas e 157 concebidas espontaneamente) desenvolvido durante um período de 16 anos num centro terciário de Obstetrícia. Foram comparados fatores demográficos, complicações obstétricas, idade gestacional no parto, tipo de parto, peso ao nascer e o outcome imediato do recém-nascido. RESULTADOS: A análise das seguintes complicações obstétricas: infecções urinárias ou outras, distúrbios hipertensivos da gravidez, diabetes gestacional, malformações fetais, morte fetal intrauterina, restrição de crescimento intrauterino e crescimento intrauterino discordante não revelou diferenças estatísticas significativas entre os dois grupos. No grupo das gestações induzidas, observou-se maior taxa de metrorragias do 1º trimestre (24 versus 8,3%, p=0,029). A taxa de cesariana foi de 52,2% nas gestações espontâneas e 64% nas gestações induzidas. Idade gestacional no parto, peso ao nascer, índice de Apgar no primeiro e quinto minutos, internamento em unidade de cuidados intensivos neonatal e complicações puerperais não apresentam diferenças estatisticamente significantes entre os dois grupos. Esses resultados foram independentes do tipo de placentação e método de indução. CONCLUSÃO: O modo de concepção não influenciou os resultados obstétricos e neonatais. Embora as gestações induzidas ten...

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Do induced twin pregnancies influence the obstetric and neonatal results of multiple births born before 32 weeks? Comparison to spontaneous gestation

Dinis¹,

Domingues²,

Belo³

et al. 2015

Rev. Bras. Ginecol. Obstet.

View full text Add to dashboard Cite

show abstract

“…We believe, therefore, that the clear distinctions reported in some of the prior studies deserve careful thought and much further research. Most of the prior studies failed to make any clear mention of the IUI categories, whereas some even grouped IUI with SC (3)(4)(5)(6)8). In our opinion, based on these vague, perhaps even confusing categorizations, the poor maternal and fetal outcomes attributed to ART have yet to be proven.…”

mentioning

confidence: 76%

Twin pregnancy outcome among cases of spontaneous conception, intrauterine insemination, and in vitro fertilization/intracytoplasmic sperm injection

Huang

Chien

et al. 2006

Fertility and Sterility

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“…Two contemporary studies found no differences in birthweight discordance by fertility treatment type, though both were more narrowly focused on comparing specific treatments and lacked a comparison group of women conceiving without fertility treatments . Older studies comparing birthweight discordance between assisted reproductive technology and twins conceived without fertility treatments found conflicting results . As has been suggested, based on the available evidence, the greater discordance observed in the medication‐only assisted reproduction group may be due to ovarian hyperstimulation resulting in embryos of different gestational ages due to superovulation or changes in the endometrial environment which negatively impact foetal growth .…”

Section: Commentmentioning

confidence: 99%

Associations between estimated foetal weight discordance and clinical characteristics within dichorionic twins: The NICHD Fetal Growth Studies

Amyx

Albert

Bever

et al. 2019

Paediatric Perinatal Epid

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Background Birthweight discordance is well studied, with less known about longitudinal inter‐twin differences in foetal growth. Objective To examine inter‐twin per cent differences in EFW (EFW%), head (HC%) and abdominal circumference (AC%), and femur length (FL%) across gestation in dichorionic twin gestations and explore associated characteristics. Methods Foetal biometrics were assessed by ultrasound and EFW calculated at ≤6 study visits among women with dichorionic twin pregnancies enrolled in the NICHD Fetal Growth Studies cohort (US, 2012‐2013). Inter‐twin per cent difference was defined: ([Sizelarger twin − Sizesmaller twin]/Sizelarger twin × 100). Linear mixed models evaluated per cent differences in foetal biometrics at 15 weeks and their change per week overall and by maternal/neonatal characteristics in unadjusted and adjusted models. Results In 140 pregnancies, inter‐twin per cent differences increased across gestation for EFW (0.18%/week, 95% confidence interval [CI] 0.10, 0.27), HC (0.03%/week, 95% CI 0.00, 0.06), and AC (0.03%/week, 95%CI −0.01, 0.08) but decreased for FL (−0.03%/week, 95% CI −0.09, 0.02). After adjustment, change in EFW% difference across gestation differed by pre‐pregnancy body mass index (BMI [kg/m2]; underweight [<18.5]; normal weight [18.5‐24.9]; overweight [25.0‐29.9]; obese [≥30.0]; Pinteraction = .022); and conception method (in vitro fertilisation [IVF], intrauterine insemination, ovulation induction medication, donor egg/embryo, none; Pinteraction = .060). While EFW% difference increased with normal pre‐pregnancy BMI (0.24%/week, 95% CI 0.12, 0.37), little change was noted with pre‐pregnancy obesity (0.01%/week, 95% CI −0.15, 0.17). EFW% difference increased in conceptions without fertility treatments (0.23%/week, 95% CI 0.11, 0.34) but not IVF conceptions (−0.00%/week, 95% CI −0.16, 0.16). Similar patterns of differences across gestation were noted for HC% by conception method (Pinteraction = .026) and AC% by pre‐pregnancy BMI (Pinteraction = .071); changes in HC% differed by parity (nulliparous, multiparous; Pinteraction = .004). Conclusions EFW% difference increased across gestation in dichorionic twins, but remained stable with pre‐pregnancy obesity or IVF conception, patterns mirrored for HC and AC. Research is needed to understand pathologic versus physiologic differential twin growth trajectories.

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Birth Weight Discordance in Spontaneous Versus Induced Twins: Impact on Perinatal Outcome

Cited by 20 publications

References 13 publications

Do induced twin pregnancies influence the obstetric and neonatal results of multiple births born before 32 weeks? Comparison to spontaneous gestation

Do induced twin pregnancies influence the obstetric and neonatal results of multiple births born before 32 weeks? Comparison to spontaneous gestation

Twin pregnancy outcome among cases of spontaneous conception, intrauterine insemination, and in vitro fertilization/intracytoplasmic sperm injection

Associations between estimated foetal weight discordance and clinical characteristics within dichorionic twins: The NICHD Fetal Growth Studies

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