OBJECTIVE: To evaluate the effect of first trimester fetal losses in singleton births from assisted reproductive technology using data from the Society for Assisted Reproductive Technology national database for 2005. DESIGN: Historic cohort study. SETTING: Clinic-based data. PATIENT(S): The study population included 21,535 singleton deliveries of >or=22 weeks gestation categorized by the number of fetal heartbeats identified on early ultrasound as one, two, three, or more. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Length of gestation, birthweight, and birthweight for gestation. Odds ratios (ORs) were calculated, with the group with one fetal heartbeat on early ultrasound as the reference. RESULT(S): Preterm birth (<37 weeks, OR 1.73; 32-36 weeks, OR 1.59; <32 weeks OR 2.56) and low birthweight (<2,500 g, OR 2.09; 1,500-2,499 g, OR 1.94) increased and term birth and nonlow birthweight decreased (OR 0.52 and 0.48) with more than one fetal heartbeat. CONCLUSION(S): Early fetal loss in pregnancies that result in a singleton live birth is associated with significantly increased odds for lowered birthweight, shortened gestation, and reduced birthweight for age. Because first trimester multiple fetal heartbeats are more common in assisted-conception pregnancies than in unassisted pregnancies, this factor may help explain the greater risk for reduced birthweight and shorter gestations observed in this population.
OBJECTIVE: To evaluate the effect of first trimester fetal losses in singleton births from assisted reproductive technology using data from the Society for Assisted Reproductive Technology national database for 2005. DESIGN: Historic cohort study. SETTING: Clinic-based data. PATIENT(S): The study population included 21,535 singleton deliveries of >or=22 weeks gestation categorized by the number of fetal heartbeats identified on early ultrasound as one, two, three, or more. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Length of gestation, birthweight, and birthweight for gestation. Odds ratios (ORs) were calculated, with the group with one fetal heartbeat on early ultrasound as the reference. RESULT(S): Preterm birth (<37 weeks, OR 1.73; 32-36 weeks, OR 1.59; <32 weeks OR 2.56) and low birthweight (<2,500 g, OR 2.09; 1,500-2,499 g, OR 1.94) increased and term birth and nonlow birthweight decreased (OR 0.52 and 0.48) with more than one fetal heartbeat. CONCLUSION(S): Early fetal loss in pregnancies that result in a singleton live birth is associated with significantly increased odds for lowered birthweight, shortened gestation, and reduced birthweight for age. Because first trimester multiple fetal heartbeats are more common in assisted-conception pregnancies than in unassisted pregnancies, this factor may help explain the greater risk for reduced birthweight and shorter gestations observed in this population.
Authors: Barbara Luke; Morton B Brown; Ethan Wantman; Judy E Stern; Valerie L Baker; Eric Widra; Charles C Coddington; William E Gibbons; Bradley J Van Voorhis; G David Ball Journal: Am J Obstet Gynecol Date: 2015-02-13 Impact factor: 8.661
Authors: Barbara Luke; Morton B Brown; Ethan Wantman; Judy E Stern; James P Toner; Charles C Coddington Journal: J Assist Reprod Genet Date: 2016-12-01 Impact factor: 3.412