Fetal Reduction Could Improve but Not Completely Reverse the Pregnancy Outcomes of Multiple Pregnancies: Experience From a Single Center
ObjectiveTo investigate the effectiveness and limitations of multifetal pregnancy reduction (MFPR) on the improvement of pregnancy outcomes of triplet or twin pregnancies conceived by in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI).MethodsWe performed a cohort study of women...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-06-01
|
| Series: | Frontiers in Endocrinology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2022.851167/full |
| _version_ | 1811238079488327680 |
|---|---|
| author | Zhu Yimin Tang Minyue Fu Yanling Yan Huanmiao Sun Saijun Li Qingfang Hu Xiaoling Xing Lanfeng |
| author_facet | Zhu Yimin Tang Minyue Fu Yanling Yan Huanmiao Sun Saijun Li Qingfang Hu Xiaoling Xing Lanfeng |
| author_sort | Zhu Yimin |
| collection | DOAJ |
| description | ObjectiveTo investigate the effectiveness and limitations of multifetal pregnancy reduction (MFPR) on the improvement of pregnancy outcomes of triplet or twin pregnancies conceived by in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI).MethodsWe performed a cohort study of women undergoing IVF or ICSI from 2002–2016 in reproductive center, women’s hospital, Zhejiang University School of Medicine. The cohort included 502 women who underwent MFPR and 9641 non-reduced women. Pregnancy outcomes were gestational age (GA) at delivery, pregnancy loss, preterm delivery, low birth weight (LBW), very low birth weight (VLBW), and small for gestational age (SGA). Multiple linear regression and logistic regression models were used to compare pregnancy outcomes between groups.ResultsTriplets reduced to singletons had a longer median GA (39.07 vs 37.00, P<0.001), and lower rates of LBW (8.9% vs 53.2%, P<0.001) and SGA (17.8% vs 44.7%, P=0.001) than triplets reduced to twins, with a similar pregnancy loss rate (6.7% vs 6.6%, P=0.701). Twins reduced to singletons had a comparable pregnancy loss rate (4.8% vs. 6.5%, P=0.40), a longer median GA (38.79 vs. 37.00, P<0.001), and lower rates of LBW (13.5% vs. 47.0%, P<0.001) and SGA (13.5% vs. 39.6%, P<0.001) than primary twins. Triplets reduced to twins had higher rates of LBW (53.2% vs. 47.0%, P=0.028) and SGA (44.7% vs. 39.6%, P=0.040) than primary twins, with a similar pregnancy loss rate (6.6% vs. 6.5%, P=0.877). Singletons reduced from triplets/twins had higher rates of preterm delivery (15.8% vs. 7.3%, P<0.001), LBW (12.3% vs. 4.32%, P<0.001), VLBW (2.3% vs. 0.4%, P=0.002), and SGA (14.6% vs.6.6%, P<0.001) than primary singletons, with a comparable pregnancy loss rate (5.3% vs. 5.4%, P=0.671).ConclusionsThis study suggests that the pregnancy loss rate is similar between reduction and non-reduction groups. MFPR improves pregnancy outcomes, including the risk of preterm delivery, LBW, and SGA, but still could not completely reverse the adverse pregnancy outcomes of multiple pregnancies. |
| first_indexed | 2024-04-12T12:35:17Z |
| format | Article |
| id | doaj.art-aa34e35d30ef40dd90cde268706b4063 |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-04-12T12:35:17Z |
| publishDate | 2022-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-aa34e35d30ef40dd90cde268706b40632022-12-22T03:32:55ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922022-06-011310.3389/fendo.2022.851167851167Fetal Reduction Could Improve but Not Completely Reverse the Pregnancy Outcomes of Multiple Pregnancies: Experience From a Single CenterZhu YiminTang MinyueFu YanlingYan HuanmiaoSun SaijunLi QingfangHu XiaolingXing LanfengObjectiveTo investigate the effectiveness and limitations of multifetal pregnancy reduction (MFPR) on the improvement of pregnancy outcomes of triplet or twin pregnancies conceived by in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI).MethodsWe performed a cohort study of women undergoing IVF or ICSI from 2002–2016 in reproductive center, women’s hospital, Zhejiang University School of Medicine. The cohort included 502 women who underwent MFPR and 9641 non-reduced women. Pregnancy outcomes were gestational age (GA) at delivery, pregnancy loss, preterm delivery, low birth weight (LBW), very low birth weight (VLBW), and small for gestational age (SGA). Multiple linear regression and logistic regression models were used to compare pregnancy outcomes between groups.ResultsTriplets reduced to singletons had a longer median GA (39.07 vs 37.00, P<0.001), and lower rates of LBW (8.9% vs 53.2%, P<0.001) and SGA (17.8% vs 44.7%, P=0.001) than triplets reduced to twins, with a similar pregnancy loss rate (6.7% vs 6.6%, P=0.701). Twins reduced to singletons had a comparable pregnancy loss rate (4.8% vs. 6.5%, P=0.40), a longer median GA (38.79 vs. 37.00, P<0.001), and lower rates of LBW (13.5% vs. 47.0%, P<0.001) and SGA (13.5% vs. 39.6%, P<0.001) than primary twins. Triplets reduced to twins had higher rates of LBW (53.2% vs. 47.0%, P=0.028) and SGA (44.7% vs. 39.6%, P=0.040) than primary twins, with a similar pregnancy loss rate (6.6% vs. 6.5%, P=0.877). Singletons reduced from triplets/twins had higher rates of preterm delivery (15.8% vs. 7.3%, P<0.001), LBW (12.3% vs. 4.32%, P<0.001), VLBW (2.3% vs. 0.4%, P=0.002), and SGA (14.6% vs.6.6%, P<0.001) than primary singletons, with a comparable pregnancy loss rate (5.3% vs. 5.4%, P=0.671).ConclusionsThis study suggests that the pregnancy loss rate is similar between reduction and non-reduction groups. MFPR improves pregnancy outcomes, including the risk of preterm delivery, LBW, and SGA, but still could not completely reverse the adverse pregnancy outcomes of multiple pregnancies.https://www.frontiersin.org/articles/10.3389/fendo.2022.851167/fullmultifetal pregnancy reductionassisted reproductive technologypregnancy outcometwinstriplets |
| spellingShingle | Zhu Yimin Tang Minyue Fu Yanling Yan Huanmiao Sun Saijun Li Qingfang Hu Xiaoling Xing Lanfeng Fetal Reduction Could Improve but Not Completely Reverse the Pregnancy Outcomes of Multiple Pregnancies: Experience From a Single Center Frontiers in Endocrinology multifetal pregnancy reduction assisted reproductive technology pregnancy outcome twins triplets |
| title | Fetal Reduction Could Improve but Not Completely Reverse the Pregnancy Outcomes of Multiple Pregnancies: Experience From a Single Center |
| title_full | Fetal Reduction Could Improve but Not Completely Reverse the Pregnancy Outcomes of Multiple Pregnancies: Experience From a Single Center |
| title_fullStr | Fetal Reduction Could Improve but Not Completely Reverse the Pregnancy Outcomes of Multiple Pregnancies: Experience From a Single Center |
| title_full_unstemmed | Fetal Reduction Could Improve but Not Completely Reverse the Pregnancy Outcomes of Multiple Pregnancies: Experience From a Single Center |
| title_short | Fetal Reduction Could Improve but Not Completely Reverse the Pregnancy Outcomes of Multiple Pregnancies: Experience From a Single Center |
| title_sort | fetal reduction could improve but not completely reverse the pregnancy outcomes of multiple pregnancies experience from a single center |
| topic | multifetal pregnancy reduction assisted reproductive technology pregnancy outcome twins triplets |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2022.851167/full |
| work_keys_str_mv | AT zhuyimin fetalreductioncouldimprovebutnotcompletelyreversethepregnancyoutcomesofmultiplepregnanciesexperiencefromasinglecenter AT tangminyue fetalreductioncouldimprovebutnotcompletelyreversethepregnancyoutcomesofmultiplepregnanciesexperiencefromasinglecenter AT fuyanling fetalreductioncouldimprovebutnotcompletelyreversethepregnancyoutcomesofmultiplepregnanciesexperiencefromasinglecenter AT yanhuanmiao fetalreductioncouldimprovebutnotcompletelyreversethepregnancyoutcomesofmultiplepregnanciesexperiencefromasinglecenter AT sunsaijun fetalreductioncouldimprovebutnotcompletelyreversethepregnancyoutcomesofmultiplepregnanciesexperiencefromasinglecenter AT liqingfang fetalreductioncouldimprovebutnotcompletelyreversethepregnancyoutcomesofmultiplepregnanciesexperiencefromasinglecenter AT huxiaoling fetalreductioncouldimprovebutnotcompletelyreversethepregnancyoutcomesofmultiplepregnanciesexperiencefromasinglecenter AT xinglanfeng fetalreductioncouldimprovebutnotcompletelyreversethepregnancyoutcomesofmultiplepregnanciesexperiencefromasinglecenter |