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

BMJ, 2004-01, Vol.328 (7434), p.261-264 [Peer Reviewed Journal]

2004 BMJ Publishing Group Ltd. ;BMJ Publishing Group Ltd 2004 ;2004 INIST-CNRS ;Copyright: 2004 (c) 2004 BMJ Publishing Group Ltd. ;Copyright © 2004, BMJ Publishing Group Ltd. 2004 ;ISSN: 0959-8138 ;ISSN: 0959-8146 ;EISSN: 1468-5833 ;EISSN: 1756-1833 ;DOI: 10.1136/bmj.37957.560278.EE ;PMID: 14742347 ;CODEN: BMJOAE

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Title:
Perinatal outcome of singletons and twins after assisted conception: a systematic review of controlled studies
Author: Helmerhorst, Frans M ; Perquin, Denise A M ; Donker, Diane ; Keirse, Marc J N C
Subjects: Biological and medical sciences ; Birth Weight ; Births ; Cesarean section ; Cesarean Section - statistics & numerical data ; Clinical outcomes ; Comparative analysis ; Conception ; Delivery. Postpartum. Lactation ; Female ; Gynecology. Andrology. Obstetrics ; Humans ; In vitro fertilization ; Infant Mortality ; Infant, Newborn ; Infant, Small for Gestational Age ; Intensive Care, Neonatal - statistics & numerical data ; Low birth weight ; Maternal, fetal and perinatal monitoring ; Medical sciences ; Mortality ; Obstetric Labor, Premature - etiology ; Obstetrics ; Pregnancy ; Pregnancy Outcome ; Pregnancy, Multiple - statistics & numerical data ; Randomized Controlled Trials as Topic ; Reproductive Techniques, Assisted - adverse effects ; Reproductive technologies ; Small for gestational age ; Twins ; Twins - statistics & numerical data
Is Part Of: BMJ, 2004-01, Vol.328 (7434), p.261-264
Description: 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.
Publisher: London: British Medical Journal Publishing Group
Language: English
Identifier: ISSN: 0959-8138
ISSN: 0959-8146
EISSN: 1468-5833
EISSN: 1756-1833
DOI: 10.1136/bmj.37957.560278.EE
PMID: 14742347
CODEN: BMJOAE
Source: MEDLINE
Alma/SFX Local Collection
ProQuest Central

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

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