Multifetal pregnancy reduction: a possible risk factor for periventricular leukomalacia in premature newborns.
OBJECTIVE
To investigate the possible role of multifetal pregnancy reduction as a risk factor for the development of periventricular leukomalacia, which has been associated with prematurity and twin pregnancies.


METHODS
A case-control study.


METHODS
In Vitro Fertilization Unit and Intensive Care Nursery of the Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.


METHODS
A total of 1,401 consecutive preterm infants who were born between January 1, 1994, and December 31, 1995.


METHODS
Cranial ultrasonographic evaluation of each infant within 3 days of birth.


METHODS
Premature infants who developed periventricular leukomalacia (cases) were compared with premature infants who did not develop this disorder (controls) when multifetal pregnancy reduction was considered.


RESULTS
Fourteen premature infants developed periventricular leukomalacia. Of these, 28.6% (4 infants) were exposed to multifetal pregnancy reduction, compared with 1.9% of the controls, giving an odds ratio (OR) of 20.9 (95% confidence interval [CI] 5.5-79.4). Adjustment of this OR for IVF treatment (OR, 18.6; 95% CI, 1.8-140.3), twinning (OR, 6.3; 95% CI, 1.3-30.3), and for both IVF treatment and twinning simultaneously (OR, 8.5; 95% CI, 1.7-42.2) did not explain all the observed associations between periventricular leukomalacia and multifetal pregnancy reduction.


CONCLUSIONS
Our data suggest that multifetal pregnancy reduction may be an additional risk factor for periventricular leukomalacia among premature infants, regardless of twinning.
Geva
E
E
Tel Aviv Sourasky Medical Center, Israel.
Lerner-Geva
L
L
Stavorovsky
Z
Z
Modan
B
B
Freedman
L
L
Amit
A
A
Yovel
I
I
Lessing
J B
JB
D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007969:Leukomalacia, Periventricular / Q000209:etiology*; D011247:Pregnancy; D018607:Pregnancy Reduction, Multifetal / Q000009:adverse effects*; D012307:Risk Factors