Perinatal outcomes in vanishing twin pregnancies following assisted reproductive technology (ART) – a systematic review and meta-analysis
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Fan Zhou
und
Xiaodong Wang
Abstract
Objectives
To compare the fetal and maternal outcomes in surviving singletons of vanishing twin, with singletons or twins, in pregnancies following assisted reproductive technology (ART).
Content
We searched the PubMed, Embase, Web of Science and Cochrane databases from the time of conception of the database until Dec 2019 to identify relevant published studies. Perinatal outcomes were synthesized with random effects meta-analysis using RevMan 5.3.
Summary and Outlook
Fifteen studies were included. Dichorionic twin pregnancies conceived by ART wherein the vanishing twin phenomenon occurred had a risk of fetal malformation similar to that of ART singleton pregnancies (OR=1.25; 95% CI 0.87–1.79) and a higher risk of fetal malformation compared with ART twin pregnancies (OR=1.82; 95% CI 1.23–2.70). Moreover, the remaining fetus in ART vanishing twin pregnancy was at a significantly higher risk of preterm birth (<37 weeks) compared to fetuses in ART singleton pregnancies (OR=2.41; 95% CI 1.46–3.99) and a markedly lower risk of preterm birth (<37 weeks) compared to the fetuses in ART twin pregnancies (OR=0.19; 95% CI 0.16–0.22). Meanwhile, the risk of delivery of infants who were small for gestational age (SGA) was significantly higher in ART vanishing twin pregnancies compared to that in ART singleton pregnancies (OR=2.70; 95% CI 1.39–5.24) and similar to that in ART twin pregnancies (OR=0.67; 95% CI 0.27–1.65).
The risks of preterm birth and of the infant being SGA is higher for the remaining fetus in an ART vanishing twin pregnancy compared to those for the fetuses in ART singleton pregnancies; the risk of fetal malformation is also higher in such cases compared with ART twin pregnancies.
Funding source: National Natural Science Foundation of China
Award Identifier / Grant number: 81801485
Funding source: The National Key Research and Development Program of China
Award Identifier / Grant number: 2018YFC10022003
Funding source: Technology Research & Development Program of Science and Technology Department of Sichuan Province
Award Identifier / Grant number: 2018SZ0127
Funding source: Research and Development Office (RDO) at the Ministry of Education, Kingdom of Saudi Arabia
Award Identifier / Grant number: HIQI-36-201
Funding source: National Natural Science Foundation of China
Award Identifier / Grant number: 81571446
Research funding: This study was funded by the National Natural Science Foundation of China (grant numbers 81801485 & 81571446), the National Key Research and Development Program of China (grant number 2018YFC10022003) and Technology Research & Development Program of Science and Technology Department of Sichuan Province (grant number 2018SZ0127).
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Competing interests: Authors state no conflict of interest.
Ethical approval: This meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement [15]. Prior to the search, a protocol regarding the study design, search methods, and inclusion and exclusion criteria was confirmed and approved by all authors. The protocol was registered at PROSPERO with number CRD42018104956.
References
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© 2020 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
- Frontmatter
- Review
- Perinatal outcomes in vanishing twin pregnancies following assisted reproductive technology (ART) – a systematic review and meta-analysis
- Mini Review
- Cervical insufficiency: a noteworthy disease with controversies
- Original Articles – Obstetrics
- Individualized birth length and head circumference percentile charts based on maternal body weight and height
- Cellular immune responses in amniotic fluid of women with a sonographic short cervix
- Comparison of buprenorphine and methadone in the management of maternal opioid use disorder in full term pregnancies
- Influence of newborn head circumference and birth weight on the delivery mode of primipara: what is more important?
- Estimated fetal weight and severe neonatal outcomes in preterm prelabor rupture of membranes
- Which technique is better to place a manoeuvrable vacuum extractor cup on the flexion point? Vacca vs. Bird technique
- Pregnancy-specific transcriptional changes upon endotoxin exposure in mice
- Effects of nifedipine on fetal cardiac function in preterm labor
- Violence against trainees: urgent ethical challenges for medical educators and academic leaders in perinatal medicine
- Original Articles – Newborns
- Comparison of image quality in brain MRI with and without MR compatible incubator and predictive value of brain MRI at expected delivery date in preterm babies
- Survey on clinical use and non-use of recombinant human erythropoietin in European neonatal units
- An alternative approach to developing guidelines for the management of an anticipated extremely preterm infant
Artikel in diesem Heft
- Frontmatter
- Review
- Perinatal outcomes in vanishing twin pregnancies following assisted reproductive technology (ART) – a systematic review and meta-analysis
- Mini Review
- Cervical insufficiency: a noteworthy disease with controversies
- Original Articles – Obstetrics
- Individualized birth length and head circumference percentile charts based on maternal body weight and height
- Cellular immune responses in amniotic fluid of women with a sonographic short cervix
- Comparison of buprenorphine and methadone in the management of maternal opioid use disorder in full term pregnancies
- Influence of newborn head circumference and birth weight on the delivery mode of primipara: what is more important?
- Estimated fetal weight and severe neonatal outcomes in preterm prelabor rupture of membranes
- Which technique is better to place a manoeuvrable vacuum extractor cup on the flexion point? Vacca vs. Bird technique
- Pregnancy-specific transcriptional changes upon endotoxin exposure in mice
- Effects of nifedipine on fetal cardiac function in preterm labor
- Violence against trainees: urgent ethical challenges for medical educators and academic leaders in perinatal medicine
- Original Articles – Newborns
- Comparison of image quality in brain MRI with and without MR compatible incubator and predictive value of brain MRI at expected delivery date in preterm babies
- Survey on clinical use and non-use of recombinant human erythropoietin in European neonatal units
- An alternative approach to developing guidelines for the management of an anticipated extremely preterm infant
