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Ottun TA, Adewunmi AA, Jinadu FO, Olumodeji AM, Akinlusi FM, Rabiu KA, Akinola OI, Fabamwo AO. A decennial cross-sectional review of assisted reproductive technology in a Tertiary Hospital in Southwest Nigeria. BMC Pregnancy Childbirth 2023; 23:680. [PMID: 37730568 PMCID: PMC10510187 DOI: 10.1186/s12884-023-05964-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 08/30/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND The World Health Organization recommends that Assisted Reproductive Technology be complementary to other ethically acceptable solutions to infertility. Whereas fertility centres are increasing in number in urban regions of Africa, published reports of their performance are sparse. We present a 10-year review of assisted reproductive technology performed in a public tertiary centre in Lagos, Nigeria. METHODS This was a hospital-based, retrospective, cross-sectional review of 604 women, over a 10-year period that had in-vitro fertilization or in-vitro fertilization with intra-cytoplasmic sperm injection at the Institute of Fertility Medicine, Lagos State University Teaching Hospital. Data obtained were expressed in descriptive statistics and Pearson correlation was used to determine the strength of linear relationship between two continuous variables at a significance level of p < 0.05. RESULTS The mean age of the women was of 37.7 ± 6.2 years and 89.7% had no previous parous experience. About 27.2% of the male partners had normal seminal fluid parameters while 4.6% had azoospermia. Median serum follicle stimulating hormone of the women was 8.1 IU/L and median serum anti-mullerian hormone was 6.3 pmol/L. There was weak positive correlation between age and serum follicle stimulating hormone (r = 0.306, p < 0.001); weak negative correlation between age and serum anti-mullerian hormone (r = -0.48, p < 0.001) and very weak correlation between body mass index and serum follicle stimulating hormone (r = 0.173, p = 0.011). In-vitro fertilization and intra-cytoplasmic sperm injection was the method of fertilization used in 97.4% of the cases and 81.8% of embryos formed were of good quality. Most women (94.5%) had 2 embryos transferred and 89.9% had day-5 embryo transfer done. About 1 in 4 of the women (143/604, 23.7%) had clinical pregnancy and 49.7% of women who got pregnant had delivery of a live baby at term while 11.9% had preterm delivery of a live baby. CONCLUSION Despite increasing use and success of assisted reproductive technology in south-western Nigeria, there is room for improvement in clinical pregnancy rates and live birth rates post- assisted reproductive technology. Complication rates are desirably low.
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Affiliation(s)
- Tawaqualit Abimbola Ottun
- Department of Obstetrics and Gynaecology, Lagos State University College of Medicine & Teaching Hospital, Lagos, Nigeria.
| | - Adeniyi Abiodun Adewunmi
- Department of Obstetrics and Gynaecology, Lagos State University College of Medicine & Teaching Hospital, Lagos, Nigeria
| | | | - Ayokunle Moses Olumodeji
- Department of Obstetrics and Gynaecology, Lagos State University Teaching Hospital, Lagos, Nigeria
| | - Fatimat Motunrayo Akinlusi
- Department of Obstetrics and Gynaecology, Lagos State University College of Medicine & Teaching Hospital, Lagos, Nigeria
| | - Kabiru Afolarin Rabiu
- Department of Obstetrics and Gynaecology, Lagos State University College of Medicine & Teaching Hospital, Lagos, Nigeria
| | - Oluwarotimi Ireti Akinola
- Department of Obstetrics and Gynaecology, Lagos State University College of Medicine & Teaching Hospital, Lagos, Nigeria
| | - Adetokunbo Olusegun Fabamwo
- Department of Obstetrics and Gynaecology, Lagos State University College of Medicine & Teaching Hospital, Lagos, Nigeria
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Dimanlig-Cruz S, Corsi DJ, Lanes A, Meng L, Miao Q, Walker M, Fell DB. Perinatal and pediatric outcomes associated with the use of fertility treatment: a population-based retrospective cohort study in Ontario, Canada. BMC Pregnancy Childbirth 2023; 23:121. [PMID: 36803122 PMCID: PMC9940338 DOI: 10.1186/s12884-023-05446-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 02/14/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Around 2% of births in Ontario, Canada involve the use of assisted reproductive technology (ART), and it is rising due to the implementation of a publicly funded ART program in 2016. To better understand the impact of fertility treatments, we assessed perinatal and pediatric health outcomes associated with ART, hormonal treatments, and artificial insemination compared with spontaneously conceived births. METHODS This population-based retrospective cohort study was conducted using provincial birth registry data linked with fertility registry and health administrative databases in Ontario, Canada. Live births and stillbirths from January 2013 to July 2016 were included and followed to age one. The risks of adverse pregnancy, birth and infant health outcomes were assessed by conception method (spontaneous conception, ART - in vitro fertilization and non-ART - ovulation induction, intra-uterine or vaginal insemination) using risk ratios and incidence rate ratios with 95% confidence intervals (CI). Propensity score weighting using a generalized boosted model was applied to adjust for confounding. RESULT(S) Of 177,901 births with a median gestation age of 39 weeks (IQR 38.0-40.0), 3,457 (1.9%) were conceived via ART, and 3,511 (2.0%) via non-ART treatments. There were increased risks (adjusted risk ratio [95% CI]) of cesarean delivery (ART: 1.44 [1.42-1.47]; non-ART: 1.09 [1.07-1.11]), preterm birth (ART: 2.06 [1.98-2.14]; non-ART: 1.85 [1.79-1.91]), very preterm birth (ART: 2.99 [2.75-3.25]; non-ART: 1.89 [1.67-2.13]), 5-min Apgar < 7 (ART: 1.28 [1.16-1.42]; non-ART: 1.62 [1.45-1.81]), and composite neonatal adverse outcome indicator (ART: 1.61 [1.55-1.68]; non-ART: 1.29 [1.25-1.34]). Infants born after fertility treatments had increased risk of admission to neonatal intensive care unit (ART: 1.98 [1.84-2.13]; non-ART: 1.59 [1.51-1.67]) and prolonged birth admission (≥ 3 days) (ART: 1.60 [1.54-1.65]; non-ART: 1.42 [1.39-1.45]). The rate of emergency and in-hospital health services use within the first year was significantly increased for both exposure groups and remained elevated when limiting analyses to term singletons. CONCLUSION(S) Fertility treatments were associated with increased risks of adverse outcomes; however, the overall magnitude of risks was lower for infants conceived via non-ART treatments.
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Affiliation(s)
- Sheryll Dimanlig-Cruz
- grid.414148.c0000 0000 9402 6172Children’s Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON Canada ,Better Outcomes Registry & Network (BORN) Ontario, Ottawa, ON Canada ,grid.28046.380000 0001 2182 2255School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON Canada
| | - Daniel J. Corsi
- Better Outcomes Registry & Network (BORN) Ontario, Ottawa, ON Canada ,grid.28046.380000 0001 2182 2255School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON Canada ,grid.412687.e0000 0000 9606 5108OMNI Research Group, Ottawa Hospital Research Institute, Ottawa, ON Canada
| | - Andrea Lanes
- Better Outcomes Registry & Network (BORN) Ontario, Ottawa, ON Canada
| | - Lynn Meng
- Better Outcomes Registry & Network (BORN) Ontario, Ottawa, ON Canada
| | - Qun Miao
- grid.414148.c0000 0000 9402 6172Children’s Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON Canada ,Better Outcomes Registry & Network (BORN) Ontario, Ottawa, ON Canada ,grid.28046.380000 0001 2182 2255School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON Canada
| | - Mark Walker
- Better Outcomes Registry & Network (BORN) Ontario, Ottawa, ON Canada ,grid.28046.380000 0001 2182 2255School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON Canada ,grid.412687.e0000 0000 9606 5108OMNI Research Group, Ottawa Hospital Research Institute, Ottawa, ON Canada ,grid.28046.380000 0001 2182 2255Department of Obstetrics and Gynecology, University of Ottawa Faculty of Medicine, Ottawa, ON Canada
| | - Deshayne B. Fell
- grid.414148.c0000 0000 9402 6172Children’s Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON Canada ,grid.28046.380000 0001 2182 2255School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON Canada
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Girardelli S, Rabaiotti E, Mauro F, Gentilini O, Zucchinelli P, Cioffi R, Valsecchi L, Mangili G, Peccatori FA, Candiani M. Weekly Paclitaxel Administered During a Twin Pregnancy for Recurrent Breast Cancer: Case Report and Review of the Literature. J Adolesc Young Adult Oncol 2022; 11:632-636. [PMID: 35180353 DOI: 10.1089/jayao.2021.0181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Although cancer treatment during single pregnancy has been standardized, how to manage cancer diagnosed during a multiple gestation is still unclear. Chemotherapy during pregnancy has shown to be safe, however, there are reports of increased risks of fetal complications such as intrauterine growth restriction and preterm birth. Also, how to best adjust this to the pharmacokinetic characteristics of a twin gestation has yet to be fully investigated. We report the case of an IVF twin pregnancy with a diagnosis of breast cancer recurrence shortly after conception, and how the pregnancy was managed to obtain optimal obstetric, maternal/oncological, and fetal outcomes.
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Affiliation(s)
- Serena Girardelli
- Department of Obstetrics and Gynecology, I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
| | - Emanuela Rabaiotti
- Department of Obstetrics and Gynecology, I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
| | - Fabio Mauro
- Department of Obstetrics and Gynecology, I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
| | - Oreste Gentilini
- Department of Breast Surgery, and I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
| | - Patrizia Zucchinelli
- Department of Oncology, I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
| | - Raffaella Cioffi
- Department of Obstetrics and Gynecology, I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
| | - Luca Valsecchi
- Department of Obstetrics and Gynecology, I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
| | - Giorgia Mangili
- Department of Obstetrics and Gynecology, I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
| | - Fedro A Peccatori
- Fertility and Procreation Unit, European Institute of Oncology IRCCS, Milan, Italy
| | - Massimo Candiani
- Department of Obstetrics and Gynecology, I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
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Premru-Srsen T, Bokal Vrtačnik E, Bizjak T, Verdenik I, Korošec S, Ban Frangež H. Preterm delivery risk in infertile women who conceived after reproductive surgery: natural conception versus IVF/ICSI. Hum Reprod 2021; 36:1630-1639. [PMID: 33527990 DOI: 10.1093/humrep/deaa380] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 12/21/2020] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION Is preterm delivery an infertility treatment-related adverse outcome in infertile women who conceived after reproductive surgery? SUMMARY ANSWER Compared with matched fertile women, preterm delivery appears to be a modest infertility treatment-related adverse outcome in infertile women who have reproductive surgery then conceived naturally or after IVF/ICSI. WHAT IS KNOWN ALREADY Most observational studies have shown that women who receive any infertility treatment are more likely to deliver preterm than do fertile women. However, studies on the outcome of pregnancies in infertile women who conceive naturally after reproductive surgery are scarce. STUDY DESIGN, SIZE, DURATION This was a single-centre historical two-part study: cohort and matched cohort study. Anonymized data of 761 infertile women who conceived after reproductive surgery and 758 fertile women were obtained by linking three computerized databases from 1 July 2012 to 31 December 2015. PARTICIPANTS/MATERIALS, SETTING, METHODS In the cohort study, we evaluated the association between the mode of conception and preterm delivery <37 and <32 gestational weeks in 703 infertile women, with a singleton pregnancy who conceived after reproductive surgery, using logistic regression adjusted for relevant co-variates to calculate the adjusted odds ratio with a 95% CI. In the matched cohort study, we evaluated preterm delivery as infertility treatment-related adverse outcome using the propensity score (PS) method. The matched cohort comprised 758 infertile women and 758 fertile women with a twin or singleton pregnancy. Infertile women conceived after reproductive surgery either naturally or through IVF/ICSI. Infertile and fertile women were matched using PS matching. Infertile and fertile women were matched for pre-defined risk factors for preterm delivery. Three infertile women out of an original 761 were not included in the analysis because they lacked all required matching variables. We performed a 1:1 matching with an optimal matching algorithm with a caliper width of the linear predictor of 0.1 standard deviations. The effect of reproductive surgery on preterm delivery was evaluated in the PS-matched sample using Pearson's χ2 test and presented as the odds ratio (OR) with 95% CI. All women delivered at the Department of Perinatology, University Medical Centre Ljubljana, Slovenia. MAIN RESULTS AND THE ROLE OF CHANCE Among 761 infertile women who conceived after reproductive surgery, 428 (56.2%) women conceived naturally and 333 (43.8%) conceived after IVF/ICSI. The incidence of twin pregnancies was significantly lower after natural conception (2.6% vs 14.1%). Among the 703 infertile women with a singleton pregnancy, 417 (59.3%) conceived naturally and 286 (40.7%) conceived after IVF/ICSI. Adjusted for maternal age and parity in infertile women with singleton pregnancies, IVF/ICSI showed a moderate association with preterm delivery <32 weeks. Compared with natural conception after reproductive surgery, the odds for preterm delivery after IVF/ICSI was 1.07 (95% CI 0.63-1.81) <37 weeks and 2.25 (95% CI 0.80-6.34) <32 weeks. Preterm delivery appears to be a modest infertility treatment-related adverse outcome. Compared with fertile women in the PS-matched sample, infertile women who conceived after reproductive surgery either naturally or after IVF/ICSI the odds of preterm delivery <37 weeks were 1.31 (95% CI 0.97-1.78) and odds of preterm delivery <32 weeks were 1.57 (95% CI 0.78-3.18). However, none of the estimations were statistically significant. LIMITATIONS, REASONS FOR CAUTION The main limitations of the study were the retrospective design, the heterogeneity of the types of reproductive surgery performed and underlying reproductive pathologies. The low number of preterm deliveries in the present study might influence the precision of estimations. WIDER IMPLICATIONS OF THE FINDINGS The present study aims to alter the prevailing opinion that reproductive surgery should only be considered preceding IVF to increase implantation and pregnancy rates after IVF. It implies that in selected infertile women who have had reproductive surgery, a high rate of natural conception, a low rate of multiple pregnancies, and a modest infertility treatment-related effect on preterm delivery should be the reasons to encourage natural conception after reproductive surgery. Furthermore, by allowing for natural conception, we can avoid a high-cost invasive medical procedure. STUDY FUNDING/COMPETING INTEREST(S) The study received no funding. We have no competing interest to declare. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Tanja Premru-Srsen
- Division of Obstetrics and Gynecology, Department of Perinatology, University Medical Centre Ljubljana, Ljubljana, Slovenia.,Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Eda Bokal Vrtačnik
- Medical Faculty, University of Ljubljana, Ljubljana, Slovenia.,Division of Obstetrics and Gynecology, Department of Human Reproduction, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Tina Bizjak
- Department of Obstetrics and Gynecology, General Hospital Slovenj Gradec, Slovenj Gradec, Slovenia
| | - Ivan Verdenik
- Division of Obstetrics and Gynecology, Research Unit, University Medical Centre, Ljubljana, Slovenia
| | - Sara Korošec
- Medical Faculty, University of Ljubljana, Ljubljana, Slovenia.,Division of Obstetrics and Gynecology, Department of Human Reproduction, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Helena Ban Frangež
- Medical Faculty, University of Ljubljana, Ljubljana, Slovenia.,Division of Obstetrics and Gynecology, Department of Human Reproduction, University Medical Centre Ljubljana, Ljubljana, Slovenia
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Ballesta-Castillejos A, Gómez-Salgado J, Rodríguez-Almagro J, Hernández-Martínez A. Development and validation of a predictive model of exclusive breastfeeding at hospital discharge: Retrospective cohort study. Int J Nurs Stud 2021; 117:103898. [PMID: 33636452 DOI: 10.1016/j.ijnurstu.2021.103898] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 01/29/2021] [Accepted: 01/30/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND The benefits of breastfeeding for both mother and newborn have been widely demonstrated. However, breastfeeding rates at discharge are lower than recommended, so being able to identify women at risk of not breastfeeding at discharge could allow professionals to prioritise care. OBJECTIVE To develop and validate a predictive model of exclusive breastfeeding at hospital discharge. DESIGN Retrospective cohort study on women who gave birth between 2014 and 2019 in Spain. DATA SOURCES The data source was a questionnaire distributed through the Spanish breastfeeding associations. The development of the predictive model was made on a cohort of 3387 women and was validated on a cohort of 1694 women. A multivariate analysis was performed by means of logistic regression, and predictive ability was determined by areas under the ROC curve (AUC). RESULTS 80.2% (2717) women exclusively breastfed at discharge in the derivation cohort, and 82.1% (1390) in the validation cohort. The predictive factors in the final model were: maternal age at birth; BMI; number of children; previous breastfeeding; birth plan; induced birth; epidural analgesia; type of birth; prematurity; multiple pregnancy; macrosomia; onset of breastfeeding within the first hour; and skin-to-skin contact. The predictive ability (ROC AUC) in the derivation cohort was 0.76 (CI 95%: 0.74-0.78), while in the validation cohort it was 0.74 (CI 95%: 0.71-0.77). CONCLUSIONS A predictive model of exclusive maternal breastfeeding at hospital discharge has been developed, based on thirteen variables, with satisfactory predictive ability in both the derivation cohort and the validation cohort according to the Swets' criteria. This model can identify women who are at high risk of not breastfeeding at hospital discharge.
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Affiliation(s)
| | - Juan Gómez-Salgado
- PhD.Department of Sociology, Social Work and Public Health, University of Huelva, 21071 Huelva, Spain; Safety and Health Posgrade Program, Universidad Espíritu Santo, Guayaquil 091650, Ecuador.
| | - Julián Rodríguez-Almagro
- PhD. Department of Nursing. Ciudad Real School of Nursing, University of Castilla La-Mancha, Ciudad Real, Spain.
| | - Antonio Hernández-Martínez
- Msc. Department of Obstetrics & Gynaecology, Alcázar de San Juan, Ciudad Real, Spain; Safety and Health Posgrade Program, Universidad Espíritu Santo, Guayaquil 091650, Ecuador.
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陈 小, 朱 金, 余 章, 姜 承, 韩 树. [Influence of twin pregnancy by assisted reproductive technology on neonatal outcomes]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2021; 23:37-42. [PMID: 33476535 PMCID: PMC7818157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 11/20/2020] [Indexed: 04/01/2024]
Abstract
OBJECTIVE To study the influence of twin pregnancy by assisted reproductive technology (ART) versus twin pregnancy by spontaneous conception (SC) on neonatal outcomes. METHODS A retrospective analysis was performed for the clinical data of 3 356 live twins with a gestational age of ≥24 weeks who were born in Nanjing Maternal and Child Health Hospital from 2017 to 2019, with 2 006 twins (1 003 pairs) in the ART group and 1 350 (675 pairs) in the SC group. The two groups were compared in terms of the mother's general information and pregnancy comorbidities and the general information, diseases, and outcomes of neonates. RESULTS Compared with the SC group, the ART group had a significantly higher maternal age (P < 0.05) and significantly higher rates of primiparity, cesarean section, and cervical cerclage (P < 0.05). Compared with the SC group, the ART group had significantly higher incidence rates of maternal pregnancy comorbidities including hypertension, gestational diabetes, and postpartum hemorrhage (P < 0.05). Compared with the SC group, the ART group had a significantly lower mean gestational age of neonates (P < 0.05) and a significantly higher proportion of very-low-birth-weight infants (6.8% vs 5.8%, P < 0.05), while ART did not increase the risks of preterm birth and low Apgar score. There were no significant differences between the two groups in the mortality rate of neonates and the incidence rates of neonatal diseases including respiratory distress syndrome, stage II/III necrotizing enterocolitis, bronchopulmonary dysplasia, and grade III-IV intracranial hemorrhage (P > 0.05). CONCLUSIONS Compared with twin pregnancy by SC, twin pregnancy by ART does not increase the neonatal mortality rate and risk of adverse outcomes.
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Affiliation(s)
- 小慧 陈
- />南京医科大学附属妇产医院/南京市妇幼保健院儿科, 江苏南京 210004Department of Pediatrics, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, China
| | - 金改 朱
- />南京医科大学附属妇产医院/南京市妇幼保健院儿科, 江苏南京 210004Department of Pediatrics, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, China
| | - 章斌 余
- />南京医科大学附属妇产医院/南京市妇幼保健院儿科, 江苏南京 210004Department of Pediatrics, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, China
| | - 承耀 姜
- />南京医科大学附属妇产医院/南京市妇幼保健院儿科, 江苏南京 210004Department of Pediatrics, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, China
| | - 树萍 韩
- />南京医科大学附属妇产医院/南京市妇幼保健院儿科, 江苏南京 210004Department of Pediatrics, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, China
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陈 小, 朱 金, 余 章, 姜 承, 韩 树. [Influence of twin pregnancy by assisted reproductive technology on neonatal outcomes]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2021; 23:37-42. [PMID: 33476535 PMCID: PMC7818157 DOI: 10.7499/j.issn.1008-8830.2009021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 11/20/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To study the influence of twin pregnancy by assisted reproductive technology (ART) versus twin pregnancy by spontaneous conception (SC) on neonatal outcomes. METHODS A retrospective analysis was performed for the clinical data of 3 356 live twins with a gestational age of ≥24 weeks who were born in Nanjing Maternal and Child Health Hospital from 2017 to 2019, with 2 006 twins (1 003 pairs) in the ART group and 1 350 (675 pairs) in the SC group. The two groups were compared in terms of the mother's general information and pregnancy comorbidities and the general information, diseases, and outcomes of neonates. RESULTS Compared with the SC group, the ART group had a significantly higher maternal age (P < 0.05) and significantly higher rates of primiparity, cesarean section, and cervical cerclage (P < 0.05). Compared with the SC group, the ART group had significantly higher incidence rates of maternal pregnancy comorbidities including hypertension, gestational diabetes, and postpartum hemorrhage (P < 0.05). Compared with the SC group, the ART group had a significantly lower mean gestational age of neonates (P < 0.05) and a significantly higher proportion of very-low-birth-weight infants (6.8% vs 5.8%, P < 0.05), while ART did not increase the risks of preterm birth and low Apgar score. There were no significant differences between the two groups in the mortality rate of neonates and the incidence rates of neonatal diseases including respiratory distress syndrome, stage II/III necrotizing enterocolitis, bronchopulmonary dysplasia, and grade III-IV intracranial hemorrhage (P > 0.05). CONCLUSIONS Compared with twin pregnancy by SC, twin pregnancy by ART does not increase the neonatal mortality rate and risk of adverse outcomes.
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Affiliation(s)
- 小慧 陈
- />南京医科大学附属妇产医院/南京市妇幼保健院儿科, 江苏南京 210004Department of Pediatrics, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, China
| | - 金改 朱
- />南京医科大学附属妇产医院/南京市妇幼保健院儿科, 江苏南京 210004Department of Pediatrics, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, China
| | - 章斌 余
- />南京医科大学附属妇产医院/南京市妇幼保健院儿科, 江苏南京 210004Department of Pediatrics, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, China
| | - 承耀 姜
- />南京医科大学附属妇产医院/南京市妇幼保健院儿科, 江苏南京 210004Department of Pediatrics, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, China
| | - 树萍 韩
- />南京医科大学附属妇产医院/南京市妇幼保健院儿科, 江苏南京 210004Department of Pediatrics, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, China
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Peregrine J, McGovern PG, Brady PC, Ginsburg ES, Schlaff W. Restoring fertility in women aged 40 years and older after tubal ligation: tubal anastomosis versus in vitro fertilization. Fertil Steril 2020; 113:735-742. [PMID: 32228877 DOI: 10.1016/j.fertnstert.2020.01.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 01/31/2020] [Indexed: 02/07/2023]
Affiliation(s)
- Jamie Peregrine
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon
| | - Peter G McGovern
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Women's Health, Rutgers-New Jersey Medical School, Newark, New Jersey
| | - Paula C Brady
- Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, New York; Columbia University Fertility Center, New York, New York
| | - Elizabeth S Ginsburg
- Department of Obstetrics and Gynecology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - William Schlaff
- Department of Obstetrics and Gynecology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania.
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