Multiple Pregnancy and Fetal Abnormalities in Association With Oral Contraceptive Usage

Macourt, David C.; Stewart, Patricia A.; Zaki, Moushira Erfan

doi:10.1111/j.1479-828x.1982.tb01393.x

Cited by 15 publications

(6 citation statements)

References 16 publications

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“…Defective nutritional intake and teratogen exposures have also been hypothesized to play a role in the formation of MZ twins [2,20]. It has been suggested that the increase in MZ twinning rates in the UK could be related to the use of oral contraceptives [13], while a large-scale Australian study showed an increased MZ twinning rate in pregnancies that had taken place following termination of oral contraception [21]. In the past, in Taiwan, oral contraceptives were less frequently used than intrauterine devices as birth control methods.…”

Section: Discussionmentioning

confidence: 99%

Secular Trend and Associated Factors of Twinning in Taiwan

Chen

Lee

Wang

et al. 1992

Acta genet. med. gemellol.: twin res.

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Delivery records of public hospitals and local health centers were analyzed to investigate the secular trend of multiple births from 1955 to 1990 in Taiwan. Twinning rates decreased gradually from the late 1950s to 1973, slightly increased and remained stable from 1974 to 1980, and then increased strikingly from 1981 to 1990. During the study period, MZ rates were consistently higher than DZ rates except in 1986 when a higher DZ rate was observed. The highest MZ rate of 7.7 per 1,000 deliveries was observed in 1985, while the highest DZ rate of 4.6 per 1,000 deliveries was observed in 1986. The triplet incidence rate also declined from the early 1960s to 1973 and then increased markedly from 1974 to 1990. A case-control study including 482 MZ and 252 DZ twin pairs and 1,496 singletons was carried out in four teaching hospitals in Taipei City between October 1985 and June 1989 to examine factors related to twinning. The zygosity of twin pairs was determined by sex, placentation and red blood cell antigens. Multiple logistic regression analysis showed that the higher the maternal age, the lower the MZ and DZ rates, while the higher the parity, the higher the rates. There was no association of paternal age or of maternal educational level with twinning rates.

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Section: Discussionmentioning

confidence: 99%

Secular Trend and Associated Factors of Twinning in Taiwan

Chen

Lee

Wang

et al. 1992

Acta genet. med. gemellol.: twin res.

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“…Some studies old studies found this link [55] but other studies did not. In a cohort (n = 732) from the Jerusalem Perinatal Study children were tested up to 3 years age.…”

Section: Family Planning 222mentioning

confidence: 94%

“…Some studies have linked previous OCs usage with twin conception [53,54,55], whereas others have not observed this association or limited its findings to OCs with high doses of estrogen [56]. Increased levels of FSH are observed in mothers of twin pregnancies; the "endocrine hypothesis" of dizygotic twin pregnancies holds that high FSH is responsible for multiple ovulation [57]; it has been suggested this mechanism might be the link between OC usage and dizygotic twin conceptions.…”

Section: Pregnancy Complications and Outcomesmentioning

confidence: 99%

Contraceptive Methods and the Subsequent Search for a Pregnancy

Balbás¹,

Balbás²,

Rivera³

2018

Family Planning

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Many women are concerned about their future fertility, about pregnancy complications and about the health of their future child when choosing a contraceptive method and sometimes women want to interrupt the contraception -maybe after years of use -in order to attempt pregnancy. Return to fertility, has been thoroughly analyzed in the literature. This chapter provides evidence-based information and discusses the potential doubts of women. Return to fertility has been consistently found to be sure, albeit sometimes slightly slow in the short term: pregnancy rates after 1 year of contraceptive interruption are 79-95% for oral contraceptives, 79-96% for levonorgestrel IUD, 71-91% for copper IUDs, around 80% for implants and 75-80% for injectable contraceptives. About 50% women are pregnant 3-6 months after contraceptive discontinuation; around 90-95% of women had achieved pregnancy 2 years after stopping their contraceptive method.Some studies have found associated risks of fetal malformations when women take oral contraceptive pills after conception (though other studies disputed these results). However the offspring of women who used oral contraceptives before conception does not show an increased risk of fetal death, miscarriage, gestational hypertension, major newborn structural defects or hypospadias. The effect on birth weight seems small and inconclusive.

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“…Regarding the first interpretation, some investigators have reported that ART promotes monozygous twinning (Alikani et al, 2003;Behr et al, 2000;Blickstein et al, 1999;Derom et al, 2001;Milki et al, 2003;Schachter et al, 2001), reporting values roughly two to 12 times the expected 0.4% monozygous twinning rate of all births from the general population (Bulmer, 1970). To explain the role of ART in monozygous twinning, various mechanistic hypotheses have been put forth, such as oral contraceptive use (Bressers et al, 1987;Macourt et al, 1982;Rothman, 1977), gonadotrophin therapy for ovarian hyperstimulation (Schachter et al, 2001), calcium reduction (Steinman, 2002;Steinman & Valderrama, 2001), zona pellucida micromanipulation (Alikani et al, 1994;Saito et al, 2000;Schieve et al, 2000;Slotnick & Ortega, 1996), blastocyst embryo transfer (Behr et al, 2000;da Costa et al, 2001;Milki et al, 2003), and the transfer of a high number of embryos (Sills et al, 2000). A definitive mechanism has not been elucidated, and it remains an area of active discussion.…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Analysis of Placentas From Twin Pregnancies Derived From Assisted Reproductive Technology

Chan

Mannino

Benirschke³

2007

Twin Res Hum Genet

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There are conflicting studies associating twin pregnancies derived from assisted reproductive technology (ART) with preterm birth, low birthweight, and other negative outcomes. This work investigates whether ART is linked with any placental pathology, given that placentation significantly influences fetal development. A 5-year, retrospective cohort study was conducted on placentas from twin pregnancies. The placental information from 417 patients was divided into two groups: placentas derived from ART and placentas derived from spontaneous pregnancies (non-ART). Available clinical information and pathologic findings from both groups then were compared. There was no statistical difference in the prevalence of placental pathology between the non-ART and ART cohorts (i.e., cord insertion, single umbilical artery, cord knot, retroplacental hemorrhage, infarction, vasculopathy, vascular anastomoses, chorangiosis, villitis, deciduitis, chorioamnionitis, meconium staining). However, 8% of ART multiple pregnancies were monochorionic. While monochorionicity is a known risk factor for adverse obstetric and neonatal outcomes, the rate of monochorionic placentation did not increase as a result of ART. Nevertheless, it is interesting to note that this small percentage of monochorionic placentation occurred in the ART cohort despite the implantation of individual embryos. Overall, the data suggests that ART does not have a role in the pathologic placentation of twin pregnancies.

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Multiple Pregnancy and Fetal Abnormalities in Association With Oral Contraceptive Usage

Cited by 15 publications

References 16 publications

Secular Trend and Associated Factors of Twinning in Taiwan

Secular Trend and Associated Factors of Twinning in Taiwan

Contraceptive Methods and the Subsequent Search for a Pregnancy

A Retrospective Analysis of Placentas From Twin Pregnancies Derived From Assisted Reproductive Technology

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