Vanishing twins: a predictor of small-for-gestational age in IVF singletons.
BACKGROUND
The purpose of this study was to assess the effect of a vanishing twin on the risk of being small-for-gestational age (SGA) in in vitro fertilization (IVF) singletons.


METHODS
The study included 642 survivors of a vanished co-twin, 5237 primary singletons and 3678 primary twins. The survivor cohort was subdivided according to gestational age at the time of vanishing to give groups of early (<8 weeks), intermediate (8-22 weeks) and late (>22 weeks) survivors.


RESULTS
The rate of SGA infants was significantly higher in survivors than in singletons (OR: 1.50, 95%CI: 1.03-2.20) and a significant inverse correlation was observed between SGA and the gestational age at the time of vanishing (r = -0.10, P < 0.02). Also in term infants, the risk of birthweight <2500 g was higher in survivors than in singletons (OR: 1.71, 95%CI: 1.06-2.74). A similar increase in the rate of low birthweight in term survivors was seen with increasing gestational age at the time of vanishing (r = -0.12; P < 0.01). In multiple logistic regression analysis adjusting for maternal age, parity, child gender and pre-eclampsia, the vanishing of a co-twin (OR: 1.56, 95%CI: 1.06-2.27) and gestational age at the time of vanishing (OR: 2.08, 95%CI: 1.00-4.35) were the only significant predictors of being SGA.


CONCLUSIONS
IVF singletons with a vanished co-twin had a higher rate of SGA than singletons from a single gestation and the risk of SGA is increased with increasing gestational age at the time of vanishing.
Pinborg
Anja
A
The Fertility Clinic, The Juliane Marie Center, Copenhagen University Hospital, Rigshopitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark. pinborg@nru.dk
Lidegaard
Ojvind
O
Freiesleben
Nina la Cour
Nl
Andersen
Anders Nyboe
AN
D000022:Abortion, Spontaneous / Q000453:epidemiology; D000328:Adult; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D004200:Diseases in Twins / Q000453:epidemiology; D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects*; D005313:Fetal Death / Q000453:epidemiology; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D011247:Pregnancy; D014427:Twins