Display Settings:

Format

Send to:

Choose Destination
See comment in PubMed Commons below
BMJ. 2004 Jan 31;328(7434):261. Epub 2004 Jan 23.

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

Author information

  • 1Department of Obstetrics, Gynaecology and Reproductive Medicine, Leiden University Medical Center, NL 2300 Leiden, Netherlands. f.m.helmerhorst@lumc.nl

Abstract

OBJECTIVE:

To compare the perinatal outcome of singleton and twin pregnancies between natural and assisted conceptions.

DESIGN:

Systematic review of controlled studies published 1985-2002.

STUDIES REVIEWED:

25 studies were included of which 17 had matched and 8 had non-matched controls.

MAIN OUTCOME MEASURES:

Very preterm birth, preterm birth, very low birth weight, low birth weight, small for gestational age, caesarean section, admission to neonatal intensive care unit, and perinatal mortality.

RESULTS:

For singletons, studies with matched controls indicated a relative risk of 3.27 (95% confidence interval 2.03 to 5.28) for very preterm (< 32 weeks) and 2.04 (1.80 to 2.32) for preterm (< 37 weeks) birth in pregnancies after assisted conception. Relative risks were 3.00 (2.07 to 4.36) for very low birth weight (< 1500 g), 1.70 (1.50 to 1.92) for low birth weight (< 2500 g), 1.40 (1.15 to 1.71) for small for gestational age, 1.54 (1.44 to 1.66) for caesarean section, 1.27 (1.16 to 1.40) for admission to a neonatal intensive care unit, and 1.68 (1.11 to 2.55) for perinatal mortality. Results of the non-matched studies were similar. In matched studies of twin gestations, relative risks were 0.95 (0.78 to 1.15) for very preterm birth, 1.07 (1.02 to 1.13) for preterm birth, 0.89 (0.74 to 1.07) for very low birth weight, 1.03 (0.99 to 1.08) for low birth weight, 1.27 (0.97 to 1.65) for small for gestational age, 1.21 (1.11 to 1.32) for caesarean section, 1.05 (1.01 to 1.09) for admission to a neonatal intensive care unit, and 0.58 (0.44 to 0.77) for perinatal mortality. The non-matched studies mostly showed similar trends.

CONCLUSIONS:

Singleton pregnancies from assisted reproduction have a significantly worse perinatal outcome than non-assisted singleton pregnancies, but this is less so for twin pregnancies. In twin pregnancies, perinatal mortality is about 40% lower after assisted compared with natural conception.

PMID:
14742347
[PubMed - indexed for MEDLINE]
PMCID:
PMC324454
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for HighWire Icon for PubMed Central Icon for PubMed Central Icon for PubMed Health
    Loading ...
    Write to the Help Desk