The effect of early fetal losses on singleton assisted-conception pregnancy outcomes.
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.


METHODS
Historic cohort study.


METHODS
Clinic-based data.


METHODS
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.


METHODS
None.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Luke
Barbara
B
Department of Obstetrics, Gynecology, and Reproductive Biology, Michigan State University, East Lansing, Michigan 48824, USA. lukeb@msu.edu
Brown
Morton B
MB
Grainger
David A
DA
Stern
Judy E
JE
Klein
Nancy
N
Cedars
Marcelle I
MI
D000022:Abortion, Spontaneous / Q000523:psychology*; D001724:Birth Weight; D005260:Female; D005313:Fetal Death / Q000453:epidemiology*; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D011247:Pregnancy; D011256:Pregnancy Outcome; D027724:Reproductive Techniques, Assisted / Q000523:psychology* / Q000706:statistics & numerical data