Impact of induced pregnancies in the obstetrical outcome of twin pregnancies

Domingues, Ana Patrícia; Dinis, Sofia Raposo; Belo, Adriana; Couto, D; Fonseca, Etelvina; Moura, Paulo

doi:10.1016/j.fertnstert.2013.09.026

Cited by 21 publications

(20 citation statements)

References 23 publications

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“…In Australia, the rate of multiple deliveries has risen by 15% from 1.3% in 1992 to 1.5% in 2012 [ 2 , 3 ]. One of the main reasons behind twining rate increase is the introduction of assisted reproductive technology (ART) [ 4 ]. The rate of twin birth is high among ART conceived children representing 43% in the US [ 5 ] and 6.8% in Australia and New Zealand [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Neonatal outcomes among twins following assisted reproductive technology: an Australian population-based retrospective cohort study

Wang

Safi

Ali

et al. 2018

BMC Pregnancy Childbirth

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BackgroundWhile their incidence is on the rise, twin pregnancies are associated with risks to the mothers and their babies. This study aims to investigate the likelihood of adverse neonatal outcomes of twins following assisted reproductive technology (ART) compared to non-ART twins.MethodsA retrospective population study using the Australian National Perinatal Data Collections (NPDC) which included 19,662 twins of ≥20 weeks gestational age or ≥ 400 g birthweight in Australia. Maternal outcomes and neonatal outcomes (preterm birth, low birth weight, resuscitation and neonatal death) were compared. Generalized Estimating Equations were used to assess the likelihood of any neonatal outcomes, with adjusted odds ratio (AOR) and 95% confidence intervals (CI) presented. Weinberg’s differential rule was used to estimate monozygotic twin rate.ResultsART mothers were 3.3 years older than non-ART mothers. The rates of pregnancy-induced hypertension and gestational diabetes were significantly higher for ART mothers than non-ART mothers (12.2% vs. 8.4%, p < 0.01) and (9.7% vs. 7.5%, p < 0.01) respectively. The incidence of monozygotic twins was 2.0% for ART twins and 1.1% for non-ART twins. Compared with non-ART twins, ART twins had higher rates of preterm birth (AOR 1.13, 95% CI: 1.05–1.22), low birth weight (AOR 1.13, 95% CI: 1.05–1.22), and resuscitation (AOR 1.26, 95% CI: 1.17–1.36). Liveborn ART twins had 28% (AOR 1.28, 95% CI 1.09–1.50) increased odds of having any adverse neonatal outcome compared to liveborn non-ART twins, especially for opposite-sex ART twins (AOR 1.42, 95% CI 1.11–1.82).ConclusionAs ART twins had higher rates of adverse outcome, special prenatal care is recommended. Couples accessing ART should be fully informed of the risk of adverse outcome of twin pregnancies.

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Section: Introductionmentioning

confidence: 99%

Neonatal outcomes among twins following assisted reproductive technology: an Australian population-based retrospective cohort study

Wang

Safi

Ali

et al. 2018

BMC Pregnancy Childbirth

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“…First, the inclusion or exclusion of chorionicity or zygosity is key in predicting perinatal outcome of twin pregnancies (22)(23)(24)(25)(26). Second, these studies do not correct for parity or socioeconomic status (27)(28)(29)(30)(31). Third, in some cohorts misclassification bias has occurred because couples were allocated to the NC group while receiving ovarian stimulation (32,33).…”

mentioning

confidence: 99%

Dizygotic twin pregnancies after medically assisted reproduction and after natural conception: maternal and perinatal outcomes

Bensdorp

Hukkelhoven

Veen

et al. 2016

Fertility and Sterility

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“…Twin pregnancies, in general, are at higher risk of numerous pregnancy complications including miscarriage or preterm birth caused by a development of two fetuses instead of one 1,2 . Adverse obstetric outcome after ART might be caused by the very procedure 4 .…”

Section: Discussionmentioning

confidence: 99%

“…Despite advances in obstetrical and neonatal care, it is well kown that twin pregnancies still carry a high risk for numerous gestational complications and adverse pregnancy outcomes [1][2][3] . Twin pregnancies are associated with low birth weight of fetuses, caesarean section, prematurity and associated perinatal morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

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Twin pregnancies concieved by assisted reproduction - early prediction of preterm birth

et al. 2020

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Background/Aim. Twins conceived by assisted reproduction techniques (ART) are the most susceptible for perinatal complications. The aim of this study was to examine the role of prenatal noninvasive fetal screening of the first and second trimester in prediction of delivery time of ART conceived twins. Methods. Prospective cohort study of all ART conceived twin pregnancies was conducted at the Clinic for Obstetrics and Gynecology, Clinical Center of Serbia, during the period from January 1, 2016 to December 31, 2017. In the 12th gestational week (GW) twins crown-rump lenght (CRL) and thickness nuchal translucency (NT) were measured ultrasonographically. Moreover, serum levels of beta subunit of human chorionic gonadotropin (β hCG) and pregnancy-associated plasma protein A (PAPPA) were assessed. In the 17th GW twins biparietal diameter (BPD), abdominal circumference (AC) and femur length (FL) were determined ultrasonografically. Additionally, β hCG, alphafetoprotein (AFP), estriol (E3) and inhibin (INH) were measured in mothers serum. The GW of delivery was noted for each pregnancy. Results. Study included 100 pregnant women with mean age 35.44 ± 5.82. In the examined sample of ART conceived twins significantly more (51%) were delivered in term (≥ 35 GW) (p = 0.001). Delivery time correlated negatively with NT and first trimester β hCG serum levels, while it correlated positively with FL of the smaller twin, second trimester β hCG, AFP and E3 concentrations. According to obtained model for prediction of delivery time in ART conceived twin pregnancies based on first trimester diagnostic tests the significant predictors were PAPPA and β hCG in the 12th GW as well as NT of the first larger twin. Nevertheless, reliability (sensitivity 50%-75%, specificity 30%-40%) of these diagnostic tests was moderate. Conclusion. Prenatal noninvasive fetal screening of the first and second trimester (ultrasonography and laboratory testing) can be used for prediction of delivery time of ART conceived twins. ApstraktUvod/Cilj. Blizanci nastali tehnikama asistirane reprodukcije (ART) su najosetljiviji na pojavu perinatalnih komplikacija. Cilj rada bio je da se ispita uloga prenatalnog neinvazivnog fetalnog skrininga prvog i drugog trimestra u predviđanju vremena porođaja blizanaca nastalih metodama ART. Metode. Prospektivna kohortna studija kojom su obuhvaćene sve blizanačke trudnoće nastale ART metodama sprovedena je na Klinici za ginekologiju i akušerstvo Kliničkog centra Srbije u periodu od 01. 01.2016. do 31.12.2017. U 12. gestacionoj nedelji (GN) ultrasonografski su blizancima izmereni razmak teme-trtica (CRL) i nuhalno zadebljanje (NT). Takođe, određeni su serumski nivoi beta podjedinice humanog horionskog gonadotropina (β hCG) i plazma proteina A povezanog sa trudnocćom (PAPPA). U 17. GN ultrasonografski su blizancima izmereni biparietalni dijametar (BPD), obim abdomena (AC) i dužine femura (FL). Pored toga, β hCG, alfa fetoprotein (AFP), estriol (E3) i inhibin (INH) su izmereni u serumu majki. Za svaku trudnocú zabeležena je G...

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Impact of induced pregnancies in the obstetrical outcome of twin pregnancies

Cited by 21 publications

References 23 publications

Neonatal outcomes among twins following assisted reproductive technology: an Australian population-based retrospective cohort study

Neonatal outcomes among twins following assisted reproductive technology: an Australian population-based retrospective cohort study

Dizygotic twin pregnancies after medically assisted reproduction and after natural conception: maternal and perinatal outcomes

Twin pregnancies concieved by assisted reproduction - early prediction of preterm birth

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