Jia-Bi Qin1, Xiao-Qi Sheng2, Hua Wang3, Guo-Chong Chen4, Jing Yang5, Hong Yu5, Tu-Bao Yang6. 1. Information Management Division, Hunan Provincial Maternal and Child Health Care Hospital, 53 Xiangchun Road, Changsha, 410008, Hunan, China. qinjiabi123@163.com. 2. Division of Medical Genetics, Hunan Provincial Maternal and Child Health Care Hospital, 53 Xiangchun Road, Changsha, 410008, Hunan, China. shengxq999@163.com. 3. Division of Medical Genetics, Hunan Provincial Maternal and Child Health Care Hospital, 53 Xiangchun Road, Changsha, 410008, Hunan, China. 4. Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China. 5. Reproductive Medicine Center, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan, China. 6. Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan, China.
Abstract
PURPOSE: To perform a systematic review and meta-analysis of reported estimates of adverse pregnancy outcomes among multiple births conceived with in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI). METHODS: PubMed, Google Scholar, Cochrane Libraries and Chinese databases were searched through May 2016 for cohort studies assessing adverse pregnancy outcomes associated with IVF/ICSI multiple births. Random-effects meta-analyses were used to calculate pooled estimates of adverse pregnancy outcomes and, where appropriate, heterogeneity was explored in group-specific analyses. RESULTS: Sixty-four studies, with 60,210 IVF/ICSI multiple births and 146,737 spontaneously conceived multiple births, were selected for analysis. Among IVF/ICSI multiple births, the pooled estimates were 51.5% [95% confidence interval (CI): 48.7-54.3] for preterm birth, 12.1% (95% CI: 10.4-14.1) for very preterm birth, 49.8% (95% CI: 47.6-52.0) for low birth weight, 8.4% (95% CI: 7.1-9.9) for very low birth weight, 16.2% (95% CI: 12.9-20.1) for small for gestational age, 3.0% (95% CI: 2.5-3.7) for perinatal mortality and 4.7% (95% CI: 4.0-5.6) for congenital malformations. When the data were restricted to twins, the pooled estimates also showed a high prevalence of adverse outcomes. There was a similar prevalence of poor outcomes among multiple births conceived with IVF/ICSI and naturally (all P ≥ 0.0792). Significant differences in different continents, countries, and income groups were found. CONCLUSIONS: The IVF/ICSI multiple pregnancies have a high prevalence of adverse pregnancy outcomes. However, population-wide prospective adverse outcomes registries covering the entire world population for IVF/ICSI pregnancies are needed to determine the exact perinatal prevalence.
PURPOSE: To perform a systematic review and meta-analysis of reported estimates of adverse pregnancy outcomes among multiple births conceived with in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI). METHODS: PubMed, Google Scholar, Cochrane Libraries and Chinese databases were searched through May 2016 for cohort studies assessing adverse pregnancy outcomes associated with IVF/ICSI multiple births. Random-effects meta-analyses were used to calculate pooled estimates of adverse pregnancy outcomes and, where appropriate, heterogeneity was explored in group-specific analyses. RESULTS: Sixty-four studies, with 60,210 IVF/ICSI multiple births and 146,737 spontaneously conceived multiple births, were selected for analysis. Among IVF/ICSI multiple births, the pooled estimates were 51.5% [95% confidence interval (CI): 48.7-54.3] for preterm birth, 12.1% (95% CI: 10.4-14.1) for very preterm birth, 49.8% (95% CI: 47.6-52.0) for low birth weight, 8.4% (95% CI: 7.1-9.9) for very low birth weight, 16.2% (95% CI: 12.9-20.1) for small for gestational age, 3.0% (95% CI: 2.5-3.7) for perinatal mortality and 4.7% (95% CI: 4.0-5.6) for congenital malformations. When the data were restricted to twins, the pooled estimates also showed a high prevalence of adverse outcomes. There was a similar prevalence of poor outcomes among multiple births conceived with IVF/ICSI and naturally (all P ≥ 0.0792). Significant differences in different continents, countries, and income groups were found. CONCLUSIONS: The IVF/ICSI multiple pregnancies have a high prevalence of adverse pregnancy outcomes. However, population-wide prospective adverse outcomes registries covering the entire world population for IVF/ICSI pregnancies are needed to determine the exact perinatal prevalence.
Authors: Katherine M Johnson; Michele R Hacker; Kim Thornton; Brett C Young; Anna M Modest Journal: Fertil Steril Date: 2020-07-22 Impact factor: 7.329
Authors: Sofie C Husen; Irene V Koning; Attie T J I Go; Irene A L Groenenberg; Sten P Willemsen; Melek Rousian; Régine P M Steegers-Theunissen Journal: Hum Reprod Date: 2021-02-18 Impact factor: 6.918