Are in vitro fertilization pregnancies with early spontaneous reduction high risk?
OBJECTIVE
The objective of the study was to determine whether spontaneous reduction in in vitro fertilization pregnancies results in outcomes comparable with in vitro fertilization singleton pregnancies or ongoing twin pregnancies.


METHODS
Women with in vitro fertilization pregnancies from 2003 to 2005 who had first-trimester ultrasound and delivered in our hospital were identified. Those with documented reduction from dichorionic twins to a single viable fetus at 14 weeks or less were categorized as spontaneous reduction pregnancies and were compared with dichorionic twin and singleton pregnancies without reduction.


RESULTS
One hundred sixty-eight singleton, 55 spontaneous reduction, and 86 twin pregnancies were included. Gestational age at delivery was similar in the singleton and spontaneous reduction groups; twins delivered significantly earlier. Spontaneous reduction was associated with lower birth weight than other singleton pregnancies (median 3062 g versus 3425 g; P = .005). The rate of pre-eclampsia was higher in pregnancies with spontaneous reduction, compared with other singleton pregnancies 9.3% versus 2.4%; P = .04).


CONCLUSIONS
Spontaneous reduction of a twin to a singleton pregnancy is associated with prolonged gestation and higher birth weight for the remaining fetus.
Chasen
Stephen T
ST
Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Weill Medical College of Cornell University, New York, NY, USA. stchasen@med.cornell.edu
Luo
Guoyang
G
Perni
Sriram C
SC
Kalish
Robin B
RB
D000022:Abortion, Spontaneous; D000328:Adult; D001724:Birth Weight; D005260:Female; D005307:Fertilization in Vitro; D005313:Fetal Death / Q000453:epidemiology; D006801:Humans; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First; D011272:Pregnancy, Multiple