OBJECTIVE: To evaluate the effect of first trimester fetal losses on twin births from assisted reproductive technology (ART). DESIGN: Historical cohort study. SETTING: Clinic-based data. PATIENT(S): The study population included 9,036 twin pregnancies of >or=22 weeks' gestation in the 2005 Society for Assisted Reproductive Technology Clinic Outcomes Reporting System database, categorized by the presence of three versus two fetal heartbeats on early ultrasound. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Length of gestation and birthweight. Adjusted odds ratios (AORs) were calculated with the group with two fetal heartbeats on early ultrasound as the reference. RESULT(S): Increased odds with three fetal heartbeats included <32 weeks, 32-36 weeks, and <37 weeks (AORs 1.47, 1.28, and 1.35, respectively) and very low birthweight (<1,500 g), moderately low birthweight (1,500-2,499 g), and low birthweight (<2,500 g) (AORs 1.69, 1.38, and 1.47, respectively). Significantly decreased odds included term birth (>or=37 weeks) and nonlow birthweight (>or=2,500 g) (AORs 0.74 and 0.68). CONCLUSION(S): Early fetal loss in assisted-conception pregnancies that result in a twin live birth is associated with significantly increased risks for lowered birthweight and shortened gestation. Because first-trimester multiple fetal heartbeats are more common in ART 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 on twin births from assisted reproductive technology (ART). DESIGN: Historical cohort study. SETTING: Clinic-based data. PATIENT(S): The study population included 9,036 twin pregnancies of >or=22 weeks' gestation in the 2005 Society for Assisted Reproductive Technology Clinic Outcomes Reporting System database, categorized by the presence of three versus two fetal heartbeats on early ultrasound. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Length of gestation and birthweight. Adjusted odds ratios (AORs) were calculated with the group with two fetal heartbeats on early ultrasound as the reference. RESULT(S): Increased odds with three fetal heartbeats included <32 weeks, 32-36 weeks, and <37 weeks (AORs 1.47, 1.28, and 1.35, respectively) and very low birthweight (<1,500 g), moderately low birthweight (1,500-2,499 g), and low birthweight (<2,500 g) (AORs 1.69, 1.38, and 1.47, respectively). Significantly decreased odds included term birth (>or=37 weeks) and nonlow birthweight (>or=2,500 g) (AORs 0.74 and 0.68). CONCLUSION(S): Early fetal loss in assisted-conception pregnancies that result in a twin live birth is associated with significantly increased risks for lowered birthweight and shortened gestation. Because first-trimester multiple fetal heartbeats are more common in ART 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; Judy E Stern; Milton Kotelchuck; Eugene R Declercq; Mark D Hornstein; Daksha Gopal; Lan Hoang; Hafsatou Diop Journal: Fertil Steril Date: 2015-05-05 Impact factor: 7.329
Authors: Barbara Luke; Judy E Stern; Mark D Hornstein; Milton Kotelchuck; Hafsatou Diop; Howard Cabral; Eugene R Declercq Journal: J Assist Reprod Genet Date: 2015-12-03 Impact factor: 3.412
Authors: Nigel Pereira; Katherine P Pryor; Allison C Petrini; Jovana P Lekovich; Jaclyn Stahl; Rony T Elias; Steven D Spandorfer Journal: J Pregnancy Date: 2016-12-22