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Risk of spontaneous preterm birth in IVF-conceived twin pregnancies
| Content Provider | Scilit |
|---|---|
| Author | Saccone, Gabriele Zullo, Fabrizio Roman, Amanda Ward, Andrew Maruotti, Giuseppe Martinelli, Pasquale Berghella, Vincenzo |
| Copyright Year | 2017 |
| Description | Journal: The Journal of Maternal-Fetal & Neonatal Medicine |
| Abstract | Objective: To compare the mean transvaginal ultrasound (TVU) cervical length (CL) at midtrimester in screening for preterm birth in in vitro (IVF)-conceived twin pregnancies versus spontaneously-conceived twin pregnancies. Methods: This was a retrospective cohort study. Potential study subjects were identified at the time of a routine second trimester fetal ultrasound exam at 18 0/7 to 23 6/7-week gestation. All women with twin diamniotic pregnancies screened with a single TVU CL for this trial were included. Mean TVU CLs were compared between IVF-conceived twin pregnancies and spontaneously-conceived twin pregnancies. The relationship of TVU CL with gestational age at delivery was assessed. Incidence of short TVU CL, defined as TVU CL ≤30 mm, was also calculated in the two groups. The primary outcome was the mean of TVU CL. Distribution of CL was determined and normality was examined in both groups Results: A total of 668 women with diamniotic twin pregnancies who underwent TVU CL screening between 18 0/6 and 23 6/7 weeks were included. 158 (23.7%) were IVF-conceived pregnancies, and 510 (76.3%) were spontaneously-conceived pregnancies. No women received progesterone, pessary, or cerclage for preterm birth prevention during pregnancy. The mean TVU CL was significantly lower in the IVF-conceived group (32.2 ± 10.5 mm) compared to the spontaneously-conceived group (34.1 ± 9.1 mm) (mean difference (MD) − 1.90 mm, 95%CI −3.72 to −0.08). The incidence of TVU CL ≤30 mm was 30.4% in the IVF-conceived group and 21.6% in the spontaneously-conceived group (adjusted odds ratio (aOR) 1.59, 95%CI 1.06–2.37). IVF-conceived twins had a significantly higher risk of spontaneous preterm birth <34 weeks (32.9 versus 21.2%; aOR 1.83, 95% confidence interval (CI) 1.23–2.71) and higher rate of delivery due to spontaneous onset of labor (64.5 versus 54.9%; aOR 1.50, 95%CI 1.03–2.17). For any given TVU CL measured between 18 0–7 and 23 6/7 weeks, gestational age at delivery for IVF-conceived twins was earlier by about 1 week on average compared with spontaneously-conceived twins. Conclusions: The higher rate of spontaneous preterm birth in IVF-conceived twin pregnancies is predicted by lower midtrimester TVU CL, as well as by the lower gestational age at birth per any given CL in the IVF-conceived compared to the spontaneously-conceived twin pregnancies. |
| Related Links | https://core.ac.uk/download/pdf/148707843.pdf |
| Ending Page | 376 |
| Page Count | 8 |
| Starting Page | 369 |
| ISSN | 14767058 |
| e-ISSN | 14764954 |
| DOI | 10.1080/14767058.2017.1378339 |
| Journal | The Journal of Maternal-Fetal & Neonatal Medicine |
| Issue Number | 3 |
| Volume Number | 32 |
| Language | English |
| Publisher | Informa UK Limited |
| Publisher Date | 2017-09-21 |
| Access Restriction | Open |
| Subject Keyword | Journal: The Journal of Maternal-Fetal & Neonatal Medicine Obstetrics and Gynecology Assisted Reproductive Technology (art) in Vitro Fertilization Preterm Birth |
| Content Type | Text |
| Subject | Pediatrics, Perinatology and Child Health Obstetrics and Gynecology |
