Hum. Reprod. Advance Access originally published online on August 29, 2007
Human Reproduction 2007 22(10):2707-2714; doi:10.1093/humrep/dem225
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Vanishing twins: a predictor of small-for-gestational age in IVF singletons
1 The Fertility Clinic, The Juliane Marie Center, Copenhagen University Hospital, Rigshopitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark 2 Department of Obstetrics and Gynecology, The Juliane Marie Center, Copenhagen University Hospital, Rigshopitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
3 Correspondence address. Tel: +45-51-26-06-18; Fax: +45-35-45-49-46; E-mail: pinborg{at}nru.dk
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.
CONCULSIONS: 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.
Key words: intrauterine growth restriction/IVF/perinatal outcome/small-for-gestational age/vanishing twin
Submitted on December 29, 2006; resubmitted on June 4, 2007; accepted on June 13, 2007.
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