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  • Title: The effect of early fetal losses on singleton assisted-conception pregnancy outcomes.
    Author: Luke B, Brown MB, Grainger DA, Stern JE, Klein N, Cedars MI, SART Writing Group.
    Journal: Fertil Steril; 2009 Jun; 91(6):2578-85. PubMed ID: 18565521.
    Abstract:
    OBJECTIVE: To evaluate the effect of first trimester fetal losses in singleton births from assisted reproductive technology using data from the Society for Assisted Reproductive Technology national database for 2005. DESIGN: Historic cohort study. SETTING: Clinic-based data. PATIENT(S): The study population included 21,535 singleton deliveries of >or=22 weeks gestation categorized by the number of fetal heartbeats identified on early ultrasound as one, two, three, or more. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Length of gestation, birthweight, and birthweight for gestation. Odds ratios (ORs) were calculated, with the group with one fetal heartbeat on early ultrasound as the reference. RESULT(S): Preterm birth (<37 weeks, OR 1.73; 32-36 weeks, OR 1.59; <32 weeks OR 2.56) and low birthweight (<2,500 g, OR 2.09; 1,500-2,499 g, OR 1.94) increased and term birth and nonlow birthweight decreased (OR 0.52 and 0.48) with more than one fetal heartbeat. CONCLUSION(S): Early fetal loss in pregnancies that result in a singleton live birth is associated with significantly increased odds for lowered birthweight, shortened gestation, and reduced birthweight for age. Because first trimester multiple fetal heartbeats are more common in assisted-conception pregnancies than in unassisted pregnancies, this factor may help explain the greater risk for reduced birthweight and shorter gestations observed in this population.
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