Neonatal outcomes of assisted and naturally conceived twins: systematic review and meta-analysis
-
A. Cristina Rossi
and
Vincenzo D'Addario
Abstract
Objective: To review the neonatal outcomes of assisted reproductive technique (ART) vs. naturally conceived (NC) twins.
Methods: A search in PubMed, Medline, EMBASE, and Cochrane library was performed (January 2000–September 2010). Articles reporting outcomes of ART vs. NC twins were classified in controlled and non-controlled studies. A sub-group was limited to unlike sex twins (UST). The MOOSE guidelines were followed. A randomized model was generated if inter-studies heterogeneity was >25%. Inter-group comparison was significant if P<0.05.
Results: Thirteen articles were reviewed. In non-controlled studies, outcomes were equal between groups, except for cesarean section rates (ART: 71.8%; NC: 49.6%; P<0.0001; OR: 2.34; 95% CI: 1.55–3.54). Similar results were obtained in controlled studies, except for higher rates of preterm delivery in ART (55%) than in NC (53%) twins (P=0.03; OR: 1.30; 95% CI: 1.03–1.65). UST differed with regard to preterm delivery (ART: 58.6%; NC: 49.5%; P<0.0001; OR: 1.51; 95% CI: 1.25–1.83), and perinatal death (ART: 3.6%; NC: 1.8%; P<0.0001; OR: 1.95; 95% CI: 1.41–2.71). Birth weight differed between groups.
Conclusion: ART twins carry increased risk of adverse outcomes. UST are at higher risk of perinatal death, although further studies are needed to assess whether chorionicity impacts on neonatal outcomes after ART.
©2011 by Walter de Gruyter Berlin Boston
Articles in the same Issue
- Review article
- Neonatal outcomes of assisted and naturally conceived twins: systematic review and meta-analysis
- Original articles – Obstetrics
- Postpartum hemorrhage in low risk population
- Perinatal mortality in preterm births: an analysis of causes, presence of substandard care and avoiding mortality in three Dutch regions
- Clinical significance of serum sRAGE and esRAGE in women with normal pregnancy and preeclampsia
- Biopsychosocial predictors of preterm delivery
- Maternal preeclampsia is associated with an increased risk of retinopathy of prematurity
- Original articles – Fetus
- Natriuretic peptide levels in intrauterine growth-restricted fetuses with absent and reversed end-diastolic flow of the umbilical artery in relation to ductus venosus flow velocities
- Inter- and intra-observer variation of fetal volume measurements with three-dimensional ultrasound in the first trimester of pregnancy
- Outcome of severe intrapartum acidemia diagnosed with fetal scalp blood sampling
- Comparison of global and regional right and left ventricular longitudinal peak systolic strain, strain rate and velocity in healthy fetuses using a novel feature tracking technique
- Contribution of twin-to-twin transfusion syndrome to preterm birth among monochorionic biamniotic and bichorionic biamniotic twin pregnancies
- Original articles – Newborn
- Historical notes on immaturity. Part 1: Measures of viability
- Historical notes on immaturity. Part 2: Surviving against the odds
- Head circumference catch-up growth among preterm very low birth weight infants: effect on neurodevelopmental outcome
- Energy metabolism in umbilical endothelial cells from preterm and term neonates
- Decision-making at the border of viability by means of values clarification: a case study to achieve distinct communication by ordinary language approach
- Neonatal morbidity in term neonates is related to gestational age at birth and level of care
- Letters to the Editor
- Effect of steroids on angiogenic factors in pregnant women with HELLP syndrome
- Acute neonatal respiratory morbidity after prior cesarean
- Congress calendar
- Congress Calendar
Articles in the same Issue
- Review article
- Neonatal outcomes of assisted and naturally conceived twins: systematic review and meta-analysis
- Original articles – Obstetrics
- Postpartum hemorrhage in low risk population
- Perinatal mortality in preterm births: an analysis of causes, presence of substandard care and avoiding mortality in three Dutch regions
- Clinical significance of serum sRAGE and esRAGE in women with normal pregnancy and preeclampsia
- Biopsychosocial predictors of preterm delivery
- Maternal preeclampsia is associated with an increased risk of retinopathy of prematurity
- Original articles – Fetus
- Natriuretic peptide levels in intrauterine growth-restricted fetuses with absent and reversed end-diastolic flow of the umbilical artery in relation to ductus venosus flow velocities
- Inter- and intra-observer variation of fetal volume measurements with three-dimensional ultrasound in the first trimester of pregnancy
- Outcome of severe intrapartum acidemia diagnosed with fetal scalp blood sampling
- Comparison of global and regional right and left ventricular longitudinal peak systolic strain, strain rate and velocity in healthy fetuses using a novel feature tracking technique
- Contribution of twin-to-twin transfusion syndrome to preterm birth among monochorionic biamniotic and bichorionic biamniotic twin pregnancies
- Original articles – Newborn
- Historical notes on immaturity. Part 1: Measures of viability
- Historical notes on immaturity. Part 2: Surviving against the odds
- Head circumference catch-up growth among preterm very low birth weight infants: effect on neurodevelopmental outcome
- Energy metabolism in umbilical endothelial cells from preterm and term neonates
- Decision-making at the border of viability by means of values clarification: a case study to achieve distinct communication by ordinary language approach
- Neonatal morbidity in term neonates is related to gestational age at birth and level of care
- Letters to the Editor
- Effect of steroids on angiogenic factors in pregnant women with HELLP syndrome
- Acute neonatal respiratory morbidity after prior cesarean
- Congress calendar
- Congress Calendar
