1.  Title: Early diagnosis, follow-up, and prenatal treatment of a case of TRAP sequence occurring in a dichorionic triamniotic triplet pregnancy. Author: Cavoretto P; Serafini A; Valsecchi L; Lanna M; Rustico MA Source: Journal of Clinical Ultrasound. 2009 Jul-Aug;37(6):350-3. Abstract: We are reporting a case of twin reversed arterial perfusion (TRAP) sequence occurring in a dichorionic triamniotic triplet pregnancy with successful percutaneous prenatal treatment and excellent neonatal outcome. TRAP sequence was diagnosed at 11 weeks in a spontaneous dichorionic-triamniotic triplet. Sonographic assessment showed persistent arterial flow and development of hydrops in the acardiac twin. Percutaneous cord interstitial laser coagulation was performed, and the co-twin subsequently developed growth restriction. The 9-month-old twins have a normal developmental course. This report confirms that fetal intervention is indicated in cases of TRAP sequence in which the acardiac twin presents a significant enlargement on follow-up sonographic examinations. Language: English Keywords: ITALY | SUMMARY REPORT | CASE HISTORIES | PREGNANT WOMEN | FETUS | MULTIPLE BIRTH | FETAL MEMBRANES | VASCULAR DISEASES | GROWTH | EXAMINATIONS AND DIAGNOSES | ULTRASONICS | AMNIOCENTESIS | PREGNANCY OUTCOMES | Developed Countries | Europe, Southern | Europe | Data Collection | Research Methodology | Population Characteristics | Demographic Factors | Population | Pregnancy | Reproduction | Diseases | Child Development | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Genetic Techniques | Laboratory Examinations and Diagnoses Document Number: 342793 |
| 2. Peer Reviewed Title: How long could we wait for the delivery of the second twin? Author: Nkwabong E; Kamgaing Noubi N; Dadje C; Mbu R Source: Tropical Doctor. 2009 Aug 11; Abstract: There is no consensus about the safe time interval between the deliveries of twins. This retrospective study, conducted from 1 January 2000 to 31 December 2004 at the University Teaching Hospital of Yaounde, Cameroon, was designed to evaluate the safe time interval between deliveries of twins. We analysed 268 twin deliveries. The mean time interval between twin deliveries was 10.0 +/- 7.9 minutes. The mean fetal weight of the first twin was 2416 +/- 565 g and that of the second was 2395 +/- 558 g. However, in 47.7% cases, the second twin was bigger than the first. When the second twin was delivered more than 30 minutes after the first, the mean 5 minute Apgar score was low. Therefore, efforts should be made to deliver the second twin within 30 minutes after the delivery of the first baby. Language: English Keywords: CAMEROON | RESEARCH REPORT | RETROSPECTIVE STUDIES | CHILDBIRTH | PREGNANCY | MULTIPLE BIRTH | TIME FACTORS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Pregnancy Outcomes | Reproduction | Population Dynamics | Demographic Factors | Population Document Number: 342543 |
| 3. Peer Reviewed Title: The rise of multiple births in Brazil. Author: da Silva CH; Goldani MZ; Silva AA; Agranonik M; Bettiol H Source: Acta Paediatrica. 2008;97(8):1019-1023. Abstract: The aim of this study was to assess the rise in multiple births and its influence on trends of low birth weight (LBW) rates in Porto Alegre, Brazil. This is a registry-based study of live births from 1994 to 2005 obtained from the national live birth information system. Chi-square tests for trends were assessed for LBW and multiple birth rates. The impact of multiple births on LBW trends was assessed by sequential modelling, including year and further adjustment for multiple births. Risk factors for multiple births were assessed using the Poisson regression. A total of 263 252 live births were studied. The LBW rate increased from 9.70% to 9.88% (p less than 0.001) and the multiple birth rate rose from 1.95% to 2.53% (p less than 0.001). LBW rate increased among twins, from 57.14% to 63.46% (p = 0.001). The twin birth rate rose by 24.7%, while the rate of triplets or higher-order increased by 150%. Multiple births may be responsible for 23.9% of the increase in the LBW rate over the period. Motherswith higher levels of schooling, older mothers and mothers delivering in private hospitals were more likely to deliver multiple births. It seems that both the increase in multiple births and in the LBW among multiple births contributed to this rise in overall LBW rate. (author's) Language: English Keywords: BRAZIL | RESEARCH REPORT | INFANT | MULTIPLE BIRTH | RISK FACTORS | LOW BIRTH WEIGHT | BIRTH ORDER | DELAYED CHILDBEARING | SOCIOCULTURAL FACTORS | DEMOGRAPHIC FACTORS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Youth | Age Factors | Population Characteristics | Population | Reproduction | Biology | Birth Weight | Body Weight | Physiology | Family Relationships | Family Characteristics | Family and Household | Reproductive Behavior | Fertility | Population Dynamics Document Number: 326627 |
| 4. Title: Birthweight and perinatal mortality among singletons and twins in north-eastern Tanzania. Author: Habib NA; Dalveit AK; Mlay J; Oneko O; Shao J Source: Scandinavian Journal of Public Health. 2008 Sep;36(7):761-8. Abstract: BACKGROUND: Low birthweights as well as high perinatal mortality rates are common in most African populations. Little is known, however, about how low birthweight corresponds with higher mortality rates within African populations. Twins are known to have lower birthweights and higher perinatal mortality rates than singletons. If lower birthweights represent higher perinatal risk per se, small twins within a population with generally lower birthweights should have critically increased risks. METHODS: In total, 15,255 births in a Tanzanian hospital during 1999-2006 were analysed to determine birthweight distribution and examine perinatal mortality rates (including stillbirths and neonatal deaths within 24 hours) by birthweight in twins and singletons. Referral births from outside the district where the hospital was situated were excluded from analysis. RESULTS: The mean birthweight for births within an estimated normal distribution was 3,172 g, with a standard deviation of 462 g. The overall perinatal mortality rate was 43.9 per 1,000 births (95% confidence interval: 40.7-47.2). Perinatal mortality rates among twins and singletons were 91.0 and 41.1 per 1000 babies respectively, corresponding to a relative risk of 2.2 (95% confidence interval: 1.7-2.8). The birthweight distribution for twins was shifted to lower birthweights. Twins had a generally lower birthweight and an excess of extremely small births as compared to singletons. The increased mortality rate for twins appeared to be independent of birthweight. CONCLUSIONS: The two-fold increased risk of perinatal death for twins was observed across the whole birthweight distribution, and very small twins appeared to have an excess perinatal risk that was almost similar to that of larger twins. Language: English Keywords: TANZANIA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | INFANT | PREVALENCE | LOW BIRTH WEIGHT | PERINATAL MORTALITY | MULTIPLE BIRTH | DEATH RATE | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Measurement | Birth Weight | Body Weight | Physiology | Biology | Mortality | Population Dynamics | Reproduction Document Number: 328824 |
5.  Peer Reviewed Title: The quantity-quality trade-off of children in a developing country: Identification using Chinese twins. Author: Li H; Zhang J; Zhu Y Source: Demography. 2008 Feb;45(1):223-243. Abstract: Testing the trade-off between child quantity and quality within a family is complicated by the endogeneity of family size. Using data from the Chinese Population Census, we examine the effect of family size on child educational attainment in China. We find a negative correlation between family size and child outcome, even after we control for the birth order effect. We then instrument family size by the exogenous variation that is induced by a twin birth and find a negative effect of family size on children's education. We also find that the effect of family size is more evident in rural China, where the public education system is poor. Given that our estimates of the effect of having twins on nontwins at least provide the lower bound of the true effect of family size, these findings suggest a quantity-quality trade-off for children in developing countries. (author's) Language: English Keywords: CHINA | RESEARCH REPORT | CORRELATION STUDIES | FAMILY SIZE | CHILDREN | MULTIPLE BIRTH | EDUCATIONAL STATUS | SCHOOL ENROLLMENT | CHILD WORTH | Asia, Eastern | Asia | Developing Countries | Statistical Studies | Studies | Research Methodology | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Reproduction | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Microeconomic Factors Document Number: 326396 |
| 6. Title: Spontaneous pregnancy after successful ICSI treatment: evaluation of risk factors in 899 families in Germany. Author: Ludwig AK; Katalinic A; Jendrysik J; Thyen U; Sutcliffe AG; Diedrich K; Ludwig M Source: Reproductive Biomedicine Online. 2008 Sep;17(3):403-9. Abstract: There are only scarce data on the incidence of spontaneous pregnancy in infertility patients. Contraception after infertility treatment is another topic that has been neglected so far. Therefore, a questionnaire was sent to 1614 couples with a child conceived by intracytoplasmic sperm injection (ICSI) aged 4-6 years. A total of 899 couples responded (response rate 55.7%). A total of 10.9% of couples had used contraception. Of the couples that had actively tried to conceive, 20.0% had conceived spontaneously, resulting in a live-birth rate of 16.4%. 74.5% of these pregnancies were conceived within 2 years after delivery. A further 26.6% of couples conceived again by ICSI, with a live-birth rate of 20.9%. Maternal age was the only prognostic factor for spontaneous conception. Parents of multiples after ICSI did not have a higher chance of spontaneous conception than parents of singletons. Couples can be counselled that one out of five couples conceive spontaneously after successful ICSI. Even when assuming that none of the families that were lost to follow-up had conceived spontaneously, one out of eight couples would have conceived spontaneously. Therefore, it is important to counsel patients about the possibility of natural conception and necessity to use contraception despite their history of subfertility. Language: English Keywords: FEDERAL REPUBLIC OF GERMANY | RESEARCH REPORT | HEALTH SURVEYS | FOLLOW-UP STUDIES | WOMEN | COUPLES | ARTIFICIAL INSEMINATION | PREGNANCY | TIME FACTORS | INFERTILITY | MULTIPLE BIRTH | COUNSELING | Developed Countries | Europe, Central | Europe | Health | Studies | Research Methodology | Demographic Factors | Population | Family Characteristics | Family and Household | Sociocultural Factors | Reproductive Technologies | Reproduction | Population Dynamics | Clinic Activities | Program Activities | Programs | Organization and Administration Document Number: 328898 |
| 7. Peer Reviewed Title: Contemporary outcomes with the latest 1000 cases of multifetal pregnancy reduction (MPR). Author: Stone J; Ferrara L; Kamrath J; Getrajdman J; Berkowitz R; Moshier E; Eddleman K Source: American Journal of Obstetrics and Gynecology. 2008 Oct;199(4):406.e1-4. Abstract: OBJECTIVE: This study was undertaken to report on the outcome of multifetal pregnancy reduction in the most up-to-date largest single center experience with this procedure, and compare the outcome to the first 1000 cases performed at the same institution. STUDY DESIGN: 1000 consecutive cases of multifetal pregnancy reduction performed at the Mount Sinai Medical Center between the years 1999-2006 were identified. Pregnancy outcomes were retrieved from a large database as well as chart review. Differences in means and proportions were evaluated by analysis of variance, chi-square, Cochran-Armitage test for trend or 2-tailed Fisher exact test as appropriate. RESULTS: Outcomes were available on 841 cases, for a follow-up rate of 84.1%; 95.2% of patients delivered after 24 weeks, for a complete loss rate of 4.7%. There was a significant trend toward decreasing loss rates with decreasing starting numbers. Mean gestational age at delivery was later, and birthweights greater, for reduction to singletons vs twins. CONCLUSION: Loss rates after multifetal pregnancy reduction have remained stable at 4.7%. The lowest loss rate occurred in the patients reducing from twins to a singleton (2.1%). Reduction to a singleton was also associated with higher birthweights and lower rates of preterm deliveries. Language: English Keywords: UNITED STATES OF AMERICA | SUMMARY REPORT | DATA ANALYSIS | PREGNANCY OUTCOMES | MULTIPLE BIRTH | GESTATIONAL AGE | BIRTH WEIGHT | Developed Countries | North America | Americas | Research Methodology | Pregnancy | Reproduction | Fetus | Body Weight | Physiology | Biology Document Number: 329075 |
| 8. Peer Reviewed Title: A population-based study of effect of multiple birth on infant mortality in Nigeria. Author: Uthman OA; Uthman MB; Yahaya I Source: BMC Pregnancy and Childbirth. 2008;8:41. Abstract: BACKGROUND: Multi-foetal pregnancies and multiple births including twins and higher order multiples births such as triplets and quadruplets are high-risk pregnancy and birth. These high-risk groups contribute to the higher rate of childhood mortality especially during early period of life. METHODS: We examined the relationship between multiple births and infant mortality using univariable and multivariable survival regression procedure with Weibull hazard function, controlling for child's sex, birth order, prenatal care, delivery assistance; mother's age at child birth, nutritional status, education level; household living conditions and several other risk factors. RESULTS: Children born multiple births were more than twice as likely to die during infancy as infants born singleton (hazard ratio = 2.19; 95% confidence interval: 1.50, 3.19) holding other factors constant. Maternal education and household asset index were associated with lower risk of infant mortality. CONCLUSION: Multiple births are strongly negatively associated with infant survival in Nigeria independent of other risk factors. Mother's education played a protective role against infant death. This evidence suggests that improving maternal education may be key to improving child survival in Nigeria. A well-educated mother has a better chance of satisfying important factors that can improve infant survival: the quality of infant feeding, general care, household sanitation, and adequate use of preventive and curative health services. Language: English Keywords: NIGERIA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | MULTIVARIATE ANALYSIS | STATISTICAL REGRESSION | INFANT | PREVALENCE | INFANT MORTALITY | MULTIPLE BIRTH | DEATH RATE | CHILD SURVIVAL | EDUCATIONAL STATUS | SOCIOECONOMIC STATUS | RISK ASSESSMENT | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Data Analysis | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Measurement | Mortality | Population Dynamics | Reproduction | Survivorship | Length of Life | Socioeconomic Factors | Economic Factors | Evaluation Document Number: 329188 |
| 9. Peer Reviewed Title: Unique case of successful twin pregnancy after spontaneous conception in a patient with uterus bicornis unicollis. Author: Arora M; Gupta N; Neelam; Jindal S Source: Archives of Gynecology and Obstetrics. 2007 Aug;276(2):193-195. Abstract: Abnormal fusion of the mullerian ducts or failure of absorption of the septum causes varying degrees of congenital uterine malformation. Twin gestation in a case of bicornuate uterus is extremely rare. We are reporting this case because of its extremely rare presentation, where twins have managed to reach term after spontaneous conception. A 28-year-old second gravida, para one was initially diagnosed to have diamniotic dichorionic twins on ultrasound. At term, she was referred to us with severe preeclamptic toxaemia. On examination, she was found to have a bicornuate uterus with one fetus in each horn. Both siblings were successfully delivered by caesarean section. So far, only one similar case has been reported following in vitro fertilisation. Although poor reproductive performance has been documented in previous reports of bicornuate uterus with twin gestation, our patient managed to reach term with delivery of healthy siblings by caesarean section. (author's) Language: English Keywords: INDIA | RESEARCH REPORT | PREGNANT WOMEN | ULTRASONICS | MULTIPLE BIRTH | UTERUS | UTERINE EFFECTS | MANAGEMENT | CHILDBIRTH | CESAREAN SECTION | INFANT HEALTH | Asia, Southern | Asia | Developing Countries | Population Characteristics | Demographic Factors | Population | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Reproduction | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Organization and Administration | Pregnancy Outcomes | Pregnancy | Obstetrical Surgery | Surgery | Treatment | Child Health Document Number: 318311 |
| 10. Title: Family size, birth order, and child IQ. Author: Black SE; Devereux PJ; Salvanes KG Source: [Unpublished] 2007. Presented at the Population Association of America 2007 Annual Meeting, New York, New York, March 29-31, 2007. [5] p. Abstract: It is clear that birth order affects children's outcomes along a number of dimensions, including education and earnings, although recent evidence from the psychology literature provides mixed evidence of the effects of birth order on IQ. The evidence on the effect of family size in the economics literature is even more mixed, with inconclusive results on all outcomes. This paper uses a large dataset on the population of Norway and focuses on the effect of birth order and family size on IQ, an outcome not previously available in datasets of this magnitude. Because of the endogeneity of family size, we instrument for family size using twin births. Importantly, we find a strong and significant effect of both birth order and family size on IQ. Our results suggest that earlier born children have higher IQs, and this effect becomes slightly larger when controls for birth characteristics are included, suggesting that it is unlikely that biological explanations for birth order effects play much role. In addition, we find that family size has a negative effect on IQ, suggesting that random shocks to family size have a negative effect on existing children. (author's) Language: English Keywords: NORWAY | RESEARCH REPORT | SUMMARY REPORT | DEMOGRAPHIC SURVEYS | CHILDREN | BIRTH ORDER | INTELLIGENCE | FAMILY SIZE | CHILD DEVELOPMENT | EDUCATIONAL STATUS | INCOME | MULTIPLE BIRTH | Europe, Northern | Europe | Developed Countries | Population Dynamics | Demographic Factors | Population | Youth | Age Factors | Population Characteristics | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Personality | Psychological Factors | Behavior | Biology | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Reproduction Document Number: 317833 |
| 11. Peer Reviewed Title: Factors associated with survival of very-low-birth-weight infants in a Brazilian fee-paying maternity in the 1990s. Author: de Mello FB; de Almeida MF; dos Santos AM; de Paula Fiod Costa H; Miyoshi MH Source: Journal of Tropical Pediatrics. 2007 Jun;53(3):153-157. Abstract: This study describes intra-hospital survival rates of very-low-birth-weight infants, as well as factors present at birth associated with survival, during a period of 10 years. This is a Retrospective cohort study performed in a 3rd level nursery at Santa Joana Maternity Hospital, a fee-paying institution in Sao Paulo, Brazil. From January 1991 to December 2000, 963 live-born infants with a birth weight of 500-1499 g, without congenital anomalies, were followed until discharge. Survival was studied according with year of birth, and stratified by birth weight and gestational age. Factors present at birth associated with survival were analyzed by logistic regression. Patient characteristics were: birth weight 500-999 g (38%), gestational ages less than or equal to 27 weeks (32%), prenatal care (100%), small for gestational age (39%), multiple gestation (22%), male (52%) and C-section (68%). According to birth weight 500-749, 750-999, 1000-1249 and 1250-1499 g, survival rate in 1991 was, respectively,0, 6, 60 and 80% and increased to 15, 71, 93 and 96% in 2000. Regarding gestational age of 24-25 weeks, 26-27 weeks and 28-31 weeks, intrahospital survival in 1991 was 0, 0 and 57%, and in 2000, improved to 44, 74 and 82%. Survival was associated with increasing birth weight (OR 0.996; CI 95%: 0.995-0.997) and gestational age (OR 0.73; CI 95%: 0.67-0.80), female gender (OR 1.52; CI 95%: 1.04-2.22) and year of birth (OR 0.70; CI 95%: 0.65-0.76). In the 1990s, survival rates among very-low-birth-weight infants improved according to year of birth, mainly in female patients with birth weight great than or equal to 750 g, and gestational age greater than or equal to 26 weeks. (author's) Language: English Keywords: BRAZIL | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | INFANT | PREGNANT WOMEN | WOMEN IN DEVELOPMENT | LOW BIRTH WEIGHT | CHILD SURVIVAL | PRIVATE SECTOR | CONGENITAL ABNORMALITIES | GESTATIONAL AGE | CESAREAN SECTION | ANTENATAL CARE | MULTIPLE BIRTH | SEX FACTORS | Developing Countries | South America, Eastern | South America | Latin America | Americas | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Birth Weight | Body Weight | Physiology | Biology | Survivorship | Length of Life | Mortality | Population Dynamics | Macroeconomic Factors | Neonatal Diseases and Abnormalities | Diseases | Fetus | Pregnancy | Reproduction | Obstetrical Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Maternal Health Services | Maternal-Child Health Services | Primary Health Care Document Number: 313543 |
| 12. Peer Reviewed Title: Successful pregnancy achieved by assisted reproductive techniques in a woman with severe congenital bicuspid aortic valve stenosis. Author: Erel CT; Erkan S; Simsek OY; Kucukoglu S Source: Archives of Gynecology and Obstetrics. 2007 Apr;275(4):299-300. Abstract: The objectives were to report a twin pregnancy achieved by assisted reproductive techniques in a woman with severe congenital bicuspid aortic valve stenosis. Intracytoplasmic sperm injection and embryo transfer was performed in a 38-year-old woman with a complaint of infertility for 8 years due to male factor and who previously had the diagnosis of severe congenital bicuspid aortic stenosis. Clinical and echocardiography follow-up during pregnancy was done. The woman had severe congenital aortic stenosis with a valve area of 0.4 cm2 and a peak gradient of 57 mmHg. In the first trial, twin pregnancy was achieved. She had an uneventful course of pregnancy in terms of cardiac functions. She underwent caesarean section at 36 weeks of gestation and had a healthy female and a male newborns. A woman with a severe congenital bicuspid aortic valve may get pregnant and deliver healthy newborns with intensive prenatal care and follow-up. The severe congenital bicuspid aortic valve stenosis may not be considered an absolute contraindication for assisted reproductive techniques and pregnancy. (author's) Language: English Keywords: TURKEY | RESEARCH REPORT | CASE STUDIES | WOMEN | INFERTILITY | EMBRYO TRANSFER | REPRODUCTIVE TECHNOLOGIES | MULTIPLE BIRTH | CARDIOVASCULAR EFFECTS | Developing Countries | Europe, Southeastern | Europe | Studies | Research Methodology | Demographic Factors | Population | Reproduction | Physiology | Biology Document Number: 313030 |
| 13. Peer Reviewed Title: Cervical cerclage for prevention of preterm birth in women with twin pregnancy. Author: Eskandar M; Shafiq H; Almushait MA; Sobande A; Bahar AM Source: International Journal of Gynecology and Obstetrics. 2007 Nov;99(2):110-112. Abstract: The objective was to compare the effect of elective cervical cerclage in women with twin pregnancy on gestational age at time of delivery. In a pragmatic fashion women in Abha Maternity Hospital, Saudi Arabia with twin gestations were allocated to receive either an elective cerclage (group I) or no cerclage (group II). Elective cerclage was performed at 12 to 14 weeks of gestation after sonographic examination of the fetus to confirm gestational age and exclude major congenital anomalies. In all cases, follow up of the pregnancy was continued until delivery. Of the 176 twin pregnancies included, cerclage was performed in 76 women, and no cerclage in 100 women. In Group I: 12 pregnancies ended in spontaneous miscarriage, 37 in preterm labor, and 27 women reached full term. There were a total of 106 live births in 62 women. In Group II: 8 women aborted, 44 women ended in preterm labor and 48 women reached full term. There were a total of 160 live births in 89 women. The gestational age at delivery ranged from 20 to 41 weeks. Multiple regression analysis did not show association between cerclage and time of delivery, although a trend was observed (P=0.056). Elective cerclage contributes little in prolongation of gestational age at the time of delivery in women with twin pregnancy, especially in women of high parity. Those with a previous history of preterm labor may be a subgroup that could benefit from elective cerclage. (author's) Language: English Keywords: SAUDI ARABIA | RESEARCH REPORT | CLINICAL TRIALS | PROSPECTIVE STUDIES | PREGNANT WOMEN | MULTIPLE BIRTH | GESTATIONAL AGE | CERVICAL EFFECTS | TREATMENT | RISK FACTORS | PREMATURE BIRTH | PREVENTION AND CONTROL | Developing Countries | Middle East | Clinical Research | Research Methodology | Studies | Population Characteristics | Demographic Factors | Population | Reproduction | Fetus | Pregnancy | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Pregnancy Outcomes | Diseases Document Number: 321416 |
| 14. Peer Reviewed Title: Time to pregnancy and multiple births. Author: Ferrari RM; Cooney MA; Vexler A; Liu A; Buck Louis GM Source: Human Reproduction. 2007 Feb;22(2):407-413. Abstract: Mothers of multiples are alleged to be more fecund than mothers of singletons. Some authors have suggested monitoring twinning rates for assessing temporal changes in a population's reproductive health. Using a nested case-control design, we estimated the odds of a multiple birth in relation to fecundity in the US Collaborative Perinatal Project inclusive of 8546 pregnant women who reported a known time-to-pregnancy (TTP) upon enrolment in the cohort, 1959-1966. Case mothers comprised 81 women giving birth to twins/triplets; control mothers comprised 243 women giving birth to singletons matched to case mothers on maternal age at a ratio of 3:1. The odds ratio (OR) for a multiple birth within 6 months of trying adjusting for maternal age and prior pregnancies was estimated using logistic regression. Discrete time Cox regression analysis was also utilized to estimate the fecundability OR. Women with a TTP of = 6 months were more likely to have a multiple birth than women reporting a TTP of > 6 months [OR = 1.95; 95% confidence interval (95% CI) = 1.09-3.51]. Excluding pregnancies after 13+ months resulted in a loss of precision (OR = 2.14; 95% CI = 0.90-5.04). These data support higher fecundity among mothers of multiples than mothers of singletons. (author's) Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | CASE CONTROL STUDIES | ESTIMATION TECHNIQUES | STATISTICAL REGRESSION | WOMEN | MULTIPLE BIRTH | TIME FACTORS | FECUNDITY | POPULATION PROJECTION | North America | Americas | Developed Countries | Studies | Research Methodology | Data Analysis | Demographic Factors | Population | Reproduction | Population Dynamics Document Number: 312198 |
| 15. Title: The comparison of twinning rates between urban and rural areas in China. Author: Gan JP; Wu ZH; Tu ZM; Zheng J Source: Twin Research and Human Genetics. 2007 Aug;10(4):633-637. Abstract: Based on the birth record data from the National Vital Statistics in the 1990 Census of China, the present study analyzed the differences between urban and rural areas on monozygotic (MZ) and dizygotic (DZ) twin rates by maternal age in 1989. The twins by zygosity were calculated with Weinberg's differential method. Results show that the MZ and DZ twinning rates in China were associated with maternal age and that there were substantial differences between urban and rural areas. The MZ twinning rates in urban and rural areas were 2.36 pairs and 2.11 pairs per 1000 deliveries respectively, significantly lower than that in most studied populations. Furthermore, our analysis indicated that MZ twinning rates remained relatively constant for mothers under the age group of 36 to 38 years, but rose over this age group in both areas, albeit with a different slope. The DZ twinning rates were strikingly affected by maternal age, but the age for peak DZ rates was found within the age group of 33 to 35 years. In all maternal age groups except for 24 to 26 years, the DZ twinning rates in urban areas were higher than in rural areas. It remains unclear as to why the DZ twinning rates reversed to reach higher values within the older maternal age groups in China, but it is almost certain that the high twinning rates had nothing to do with in vitro fertilization. (excerpt) Language: English Keywords: CHINA | RESEARCH REPORT | DATA ANALYSIS | COMPARATIVE STUDIES | MOTHERS | MULTIPLE BIRTH | POPULATION GENETICS | RURAL AREAS | URBAN AREAS | MATERNAL AGE | Asia, Eastern | Asia | Developing Countries | Research Methodology | Studies | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Reproduction | Genetics | Biology | Geographic Factors | Population | Parental Age | Age Factors | Population Characteristics | Demographic Factors Document Number: 320804 |
| 16. Peer Reviewed Title: Treatment of twin reversed arterial perfusion sequence by septostomy and amniodrainage: A case report. Author: Guimaraes Filho HA; da Costa Lavoisier Linhares D; Araujo Junior E; Sato M; Nardozza LM Source: Archives of Gynecology and Obstetrics. 2007 Jun;275(6):489-493. Abstract: An acardiac fetus is the most severe malformation seen in humans. It is an extremely rare complication, occurring in approximately 1% of all monozygotic twin gestations, with an incidence of about 1 in 35,000 births. This malformation happens as a result of the syndrome of reversed arterial perfusion of the acardiac twin from the other normal fetus (pump twin), due to the presence of arterio-arterial anastomoses in a monochorionic placenta. Several obstetric and perinatal complications have been associated to this anomaly and several treatments have been proposed to reduce the morbimortality of the pump twin. There's no report in MEDLINE about the treatment of twin gestations with acardiac fetus through septostomy. The present article reports a case of reversed arterial perfusion sequence complicated by polyhydramnios diagnosed at 19th week of pregnancy, treated with septostomy and serial amniodrainage. This case presented it demonstrate favorable development of the gestation, with labor happeningat 35 weeks gestation and pump twin presenting good vitality conditions. In cases with no major factors of bad prognosis, septostomy combined with amniodrainage could be an interesting therapeutic option for a safe and efficacious management of selected cases of TRAP sequence. (author's) Language: English Keywords: BRAZIL | RESEARCH REPORT | INCIDENCE | FETUS | MULTIPLE BIRTH | ARTERIAL OCCLUSIVE DISEASES | MORBIDITY | INFANT MORTALITY | PREGNANCY COMPLICATIONS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Measurement | Research Methodology | Pregnancy | Reproduction | Vascular Diseases | Diseases | Mortality | Population Dynamics | Demographic Factors | Population Document Number: 317128 |
| 17. Title: Fetal growth and neonatal mortality in Korea. Author: Hong JS; Yi SW; Han YJ; Park YW; Nam CM Source: Paediatric and Perinatal Epidemiology. 2007 Sep;21(5):397-410. Abstract: The fetal growth curve and neonatal mortality rate, based on gestational age and birthweight, are important for identifying groups of high-risk neonates and developing appropriate medical services and health-care programmes. The purpose of this study was to develop a national fetal growth curve for neonates in Korea, and examine the Korean national references for fetal growth and death according to their characteristics. Data of Korean vital statistics linked National Infant Mortality Survey conducted on births in 1999 were used in this study. The total livebirths were 621 764 in 1999, which were grouped into singletons (n = 609 643) and twins (n = 9805) for analysis. Birthweight/gestational age-specific fetal growth curves and neonatal mortality rates were based on 250 g of birthweight and weekly gestational age intervals for each characteristic of the birth. The features of high-risk neonates such as small-for-gestational-age and the limit of viability in Korea were different from those of Western countries. Difference in fetal growth and death was also detected in other characteristics of the fetus (gender and plurality of birth) besides race. The fetal growth curve of males was higher than that of females, and was higher in singleton than in twins. The neonatal mortality rate was higher in males (singleton, 2.6; twin, 23.5) than females (singleton, 2.1; twin, 15.9), and higher in twins (19.8/1000) than in singletons (2.4/1000). However, in neonates with gestational age >29 weeks and birthweight >1000 g, the neonatal mortality rate was lower in twins than in singletons. The limit of viability was gestational age 27 weeks and birthweight 1000 g, which was similar in singletons and twins regardless of gender. To improve the health of neonates in a country, it is imperative to investigate the characteristics of fetal growth and death under the particular circumstances of the country. When risk is defined for neonates account must be taken of differences in race, gender and plurality of birth, as the neonatal mortality rate varies depending on those factors. (author's) Language: English Keywords: REPUBLIC OF KOREA | RESEARCH REPORT | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | INFANT | FETUS | MULTIPLE BIRTH | ETHNIC GROUPS | NEONATAL MORTALITY | INTRAUTERINE GROWTH RETARDATION | BIRTH WEIGHT | GESTATIONAL AGE | RISK FACTORS | SEX FACTORS | DEATH RATE | Asia, Eastern | Asia | Developed Countries | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Pregnancy | Reproduction | Cultural Background | Infant Mortality | Mortality | Population Dynamics | Congenital Abnormalities | Neonatal Diseases and Abnormalities | Diseases | Body Weight | Physiology | Biology Document Number: 319452 |
| 18. Peer Reviewed Title: Twin weight discordance and maternal weight gain in twin pregnancies. Author: Lee KJ; Hur J; Yoo J Source: International Journal of Gynecology and Obstetrics. 2007 Mar;96(3):176-180. Abstract: The objective was to evaluate the association between twin weight discordance and maternal weight change during the gestational period. One hundred forty-seven twin pregnancies (Group A: < 25%, Group B: = 25% birth weight discordance) were analyzed using Student's t-test, 2-test, and two-way ANOVA at three gestational intervals: before 18 weeks, 18 to 28 weeks, and 28 weeks to birth. There was no statistically significant difference between the two groups involving maternal age, parity, duration of pregnancy, height, pregravid weight, and conception method. Group A showed a pattern of constantly increasing maternal weight without a significant change in the twin weight discordance throughout gestation. However, Group B showed a fluctuation in maternal BMI with remarkably elevated twin weight discordance at 28 weeks to birth. The results suggest that in twin pregnancies constant maternal weight gain throughout gestation is important for maintaining a twin weight discordance of less than 25%. (author's) Language: English Keywords: REPUBLIC OF KOREA | RESEARCH REPORT | RETROSPECTIVE STUDIES | PREGNANT WOMEN | INFANT | MULTIPLE BIRTH | BODY WEIGHT | BIRTH WEIGHT | ULTRASONICS | ANTENATAL CARE | Developed Countries | Asia, Eastern | Asia | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Youth | Age Factors | Reproduction | Physiology | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Maternal Health Services | Maternal-Child Health Services | Primary Health Care Document Number: 312667 |
| 19. Peer Reviewed Title: Septostomy with amniodrainage in the treatment of twin-to-twin transfusion syndrome: a 16-case report. Author: Saito M; Pontes AL; Filho FA; Sousa FL; Saito M Source: Archives of Gynecology and Obstetrics. 2007 May;275(5):341-345. Abstract: The objective was to report the treatment results of 16 monochorionic and diamniotic gestations cases, which had complications due to the twin-to-twin transfusion syndrome (TTTS), the neonatal and other possible complications of the septostomy associated to the amniodrainage. Based on ultrasonographic findings, 16 pregnant women were diagnosed with the twin-to-twin transfusion syndrome (TTTS). These cases were divided in two groups: one of them included the fetuses without hydrops and the second included the "recipient" fetuses with hydrops. The therapy measures included septostomy with or without amniodrainage. The following parameters were evaluated: gestational age at the time the septostomy was performed, volume of drained amniotic fluid, gestational age at delivery, birth weight, postnatal evolution, and procedure complications. The average gestational age for this procedure was of 23.6 weeks (from 14 weeks and 1 day to 33 weeks). The gestational age for the septostomy until the delivery was of 8.18 weeks (from 1.0 to 21.3 weeks). The survival rate in the group without hydrops was of 68.7%, while in the second group it was of 25%. Some of the complications were as follows: two cases of premature membrane rupture and one case of preterm labor. Septostomy with amniodrainage, when performed on the initial stages and on earlier gestational ages has good perinatal results. (author's) Language: English Keywords: BRAZIL | RESEARCH REPORT | CASE STUDIES | PREGNANT WOMEN | PREGNANCY OUTCOMES | MULTIPLE BIRTH | AMNIOCENTESIS | SURGERY | Developing Countries | South America, Eastern | South America | Latin America | Americas | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Pregnancy | Reproduction | Genetic Techniques | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Treatment Document Number: 315236 |
| 20. Peer Reviewed Title: Twin pregnancy outcomes in the Maltese Islands. Author: Savona-Ventura C; Gatt M; Zammit K; Grima S Source: International Journal of Gynecology and Obstetrics. 2007 Sep;98(3):255-256. Abstract: Multiple births have increased significantly in the last decades throughout the developed world, including the Maltese Islands, as a result of increasing use of artificial reproductive technology. In spite of advances in obstetric care seen throughout the second half of the twentieth century, the perinatal outcomes associated with a multiple pregnancy remain associated with increased morbidity and mortality for the mother and infants. This study attempts to assess the characteristics and outcomes of these pregnancies in the Maltese population. The Maltese national maternity data for 2000-2004 were analyzed [19,935 maternities; 20,215 births] and various outcome parameters were statistically compared between twin and singleton births using the chi square test. (excerpt) Language: English Keywords: MALTA | RESEARCH REPORT | PREGNANCY | PREGNANCY OUTCOMES | RISK FACTORS | PREGNANCY COMPLICATIONS | MULTIPLE BIRTH | Europe, Southern | Europe | Developed Countries | Reproduction | Biology | Diseases Document Number: 319400 |
| 21. Title: Long-term neurodevelopmental outcome of triplets. Author: Skrablin S; Kuvacic I; Simunic V; Bosnjak-Nadj K; Kalafatic D Source: European Journal of Obstetrics, Gynecology and Reproductive Biology. 2007 May;132(1):76-82. Abstract: The objective was to analyze the incidence of neurodevelopmental disabilities in triplets and to find out possible connection between the outcome and perinatal events. Retrospective cohort study of 94 triplets and their outcome at 24-144 months of age correlated with gestational age, birth weight, pregnancy complications, early neonatal period, neonatal cranial ultrasound, period of birth (1985-1995, 1996-2000) and type of antenatal care. Sixty-two triplets are healthy, 15 suffer cerebral palsy (CP) and 17 minimal cerebral dysfunction (MCD). Adverse outcome correlates significantly with prematurity, low birth weight and maternal age. In multivariate analysis, both cerebral palsy and minor disabilities correlate significantly with early neonatal complications, neonatal cranial ultrasound with later CP (p less than 0.01), and MCD with preterm rupture of membranes (p = 0.047). Children conceived spontaneously do worse than those born after assisted reproduction (p = 0.004), those born in the time period 1996-2000 do better than those born before (p = 0.021). Seventy-seven percent (77%) of newborns delivered in the time period 1996-2000 and after level 1 antenatal care was introduced, compared with 54% being delivered in the time period before 1996 and with less meticulous types of antenatal care, remain healthy (p = 0.015). Triplets are still at high risk for long-term neurodevelopmental complications. Stringent perinatal care might appear important determinant of their long-term outcome. (author's) Language: English Keywords: CROATIA | RESEARCH REPORT | COHORT ANALYSIS | CHILDREN | MULTIPLE BIRTH | NEUROLOGIC EFFECTS | CHILD DEVELOPMENT | RISK FACTORS | PREMATURE BIRTH | LOW BIRTH WEIGHT | MATERNAL AGE | Developing Countries | Europe, Southeastern | Europe | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Reproduction | Physiology | Biology | Pregnancy Outcomes | Pregnancy | Birth Weight | Body Weight | Parental Age Document Number: 313447 |
| 22. Title: Early prediction of preterm birth for singleton, twin, and triplet pregnancies. Author: Tan H; Wen SW; Chen XK; Demissie K; Walker M Source: European Journal of Obstetrics, Gynecology and Reproductive Biology. 2007 Apr;131(2):132-137. Abstract: Objectives: To create prediction models of early preterm birth for singletons, twin, and triplet pregnancies. Study design: We used a historical cohort study with the 1996 birth registration data for singletons and the 1995-1997 linked birth/infant death dataset for multiple births of the United States. Preterm birth was defined as gestational age <32 completed weeks. Eligible study subjects were randomly allocated to two groups: one group (80% subjects) for the creation of the prediction models, and the other group (20% subjects) for the validation of the established prediction models. Multivariate logistic regressions were used to establish the prediction models. We further assessed the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the established prediction models with different cut-off values in the validation group. Results: The sensitivity, specificity, PPV, and NPV of the established model were 24.58, 93.54, 5.91, and 98.69%, respectively for singletons, 64.66, 57.04, 16.29, and 92.59%, respectively for twins, and 63.57, 53.58, 42.96, and 72.78%, respectively for triplets. Conclusion: The prediction models of early preterm birth for singleton, twin, and triplet pregnancies created by this study could be useful for obstetricians to identify women being at high risk of preterm birth at early gestation. (author's) Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | THEORETICAL STUDIES | MATHEMATICAL MODEL | COHORT ANALYSIS | EPIDEMIOLOGIC METHODS | MULTIVARIATE ANALYSIS | WOMEN | PREMATURE BIRTH | RISK ASSESSMENT | MULTIPLE BIRTH | RISK FACTORS | North America | Americas | Developed Countries | Theoretical Models | Research Methodology | Data Analysis | Demographic Factors | Population | Pregnancy Outcomes | Pregnancy | Reproduction | Evaluation | Biology Document Number: 313279 |
| 23. Peer Reviewed Title: What is the optimal gestational age for twin delivery. Author: Bakr AF; Karkour T Source: BMC Pregnancy and Childbirth. 2006 Feb 16;6:3. Abstract: The question about outcome in twins delivered early versus late remains unanswered. The objective of this study was to evaluate the association of the timing of delivering twins and the perinatal outcome. A prospective cohort study was carried-out in Alexandria University Maternity Hospital. We planned to examine the records of twin deliveries over 2 years. The inclusion criteria were twin deliveries with gestational age at delivery at least 36 completed weeks. Twins of mothers with chronic illness and those with congenital anomalies were excluded. Perinatal outcome parameters (morbidity and mortality) were defined and evaluated. Out of 273 twin sets, 197 (72.2%) met the inclusion criteria. They were classified into 3 groups according to the gestational age at delivery. Neonatal morbidity and maternal complications were higher in those delivered earlier. Twins electively delivered had worse outcome than those delivered spontaneously. In the elective group, there was no difference in the outcome between those delivered earlier or later. Twins, when the pregnancy is uncomplicated, continue to grow and mature with advancement of the gestational age. In the absence of significant maternal complications, it is advisable to deliver twins only at 38 completed weeks' gestation or later to avoid neonatal complications. (author's) Language: English Keywords: EGYPT | RESEARCH REPORT | PROSPECTIVE STUDIES | INFANT | MULTIPLE BIRTH | PREGNANCY OUTCOMES | GESTATIONAL AGE | CHILDBIRTH | BEST PRACTICES | INFANT HEALTH | Africa, North | Africa | Developing Countries | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Reproduction | Pregnancy | Fetus | Programs | Organization and Administration | Child Health | Health Document Number: 297370 |
| 24. Peer Reviewed Title: Teen maternal age and very preterm birth of twins. Author: Branum AM Source: Maternal and Child Health Journal. 2006 May;10(3):229-233. Abstract: As teen singleton pregnancy is associated with higher risks of adverse birth outcome, and twin pregnancy, regardless of maternal age, may result in poor outcome, teens pregnant with twins may represent a particularly vulnerable group. However, little has been documented regarding teen twin pregnancy outcome. The objective was to characterize the risk of very preterm birth among teens having twins. Design: Cross-sectional analysis of the US 1995--2000 Matched Multiple Birth Data Set. Methods: We calculated the risk of very preterm birth (< 33 weeks' gestation) for teen and young adult mothers of twins (= 16 years, 17-- 18 years, 19--20 years), compared to 21--24 year olds, stratified by race/ethnicity. Adjusted odds ratios were estimated controlling for marital status and entry into prenatal care. Odds of very preterm birth decreased significantly with increasing age. Odds ratios ranged from 2.07 (1.73, 2.48) to 1.20 (1.11, 1.29) according to maternal age for White teen mothers, from 1.76 (1.48, 2.09) to 1.13 (1.03, 1.24) for Black teen mothers, and from 2.19 (1.77, 2.72) to 1.15 (1.02, 1.31) for Hispanic teen mothers. Odds of very preterm birth among teen mothers of twins were about the same as those for teen mothers of singletons. Teens having twins have higher odds of very preterm birth than young adult mothers. However, the association between age and preterm birth was similar among teen mothers having twins as for those having singletons. (author's) Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | VITAL STATISTICS | ADOLESCENT PREGNANCY | MULTIPLE BIRTH | PREMATURE BIRTH | AGE FACTORS | North America | Americas | Developed Countries | Research Methodology | Population Statistics | Reproductive Behavior | Fertility | Population Dynamics | Demographic Factors | Population | Reproduction | Pregnancy Outcomes | Pregnancy | Population Characteristics Document Number: 302342 |
| 25. Title: Sonographic prediction of significant intertwin birth weight discordance. Author: Chang YL; Chang TC; Chang SD; Cheng PJ; Chao AS Source: European Journal of Obstetrics, Gynecology and Reproductive Biology. 2006 Jul;127(1):35-40. Abstract: The objective was to evaluate the usefulness of sonographic prediction of significant birth weight discordance in twin pregnancies. Included in the study were live twin pairs with a gestational age of 24 weeks at birth who had received a sonographic examination within 28 days of delivery. Correlation tests and ROC curves were used to evaluate the predictability of significant intertwin growth discordance. A total of 575 twin pregnancies were included in the study. The estimated discordance by sonographic examination proved to be an effective predictor of discordant twin growth. The birth weight discordance estimated by sonography tended to underestimate the degree of discordant twins. If a sonographic examination is done within 28 days of delivery, it is a reliable predictor of twin birth weight discordance at the following levels: 15%, 20%, 25% or 30%. In order to obtain a higher sensitivity, the cut-off value of estimated birth weight discordance needs to be decreased by 5%. (author's) Language: English Keywords: TAIWAN | RESEARCH REPORT | RETROSPECTIVE STUDIES | MULTIPLE BIRTH | FETUS | BIRTH WEIGHT | EXAMINATIONS AND DIAGNOSES | ULTRASONICS | Asia, Eastern | Asia | Developed Countries | Studies | Research Methodology | Reproduction | Pregnancy | Body Weight | Physiology | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 303058 |
| 26. Peer Reviewed Title: Mifepristone-induced abortion in one horn and a growing fetus in another horn in a patient with a twin pregnancy in a bicornuate uterus. Author: Chao A; Chao AS; Wang ST; Wang TH Source: Fertility and Sterility. 2006 Dec;86(6):1764.e3-1764.e5. Abstract: The objective was to report a case of mifepristone-induced abortion in only one horn but a growing fetus in another horn for a twin pregnancy in a bicornuate uterus. Design: Case report. Setting: Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taiwan. Patient(s): A 31-year-old woman who conceived spontaneously presented with 37 days' gestation. Intervention(s): Mifepristone 600 mg orally followed by misoprostol 400 µg orally 2 days later. Main Outcome Measure(s): Termination of pregnancy. Induced abortion in only one horn but a growing fetus in another horn for a twin pregnancy in the bicornuate uterus detected by ultrasound. Surgical abortion with vacuum curettage was performed, and menstruation resumed 1 month later. As medical abortion with mifepristone and misoprostol becomes more prevalent, more studies are necessary to establish the dosage and regimens for multiple pregnancies associated with uterine anomalies. (author's) Language: English Keywords: TAIWAN | RESEARCH REPORT | CASE STUDIES | PREGNANT WOMEN | ABORTION | RU-486 | MULTIPLE BIRTH | Asia, Eastern | Asia | Developed Countries | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Fertility Control, Postconception | Family Planning | Hormone Antagonists | Hormones | Endocrine System | Physiology | Biology | Reproduction Document Number: 310577 Notification |
| 27. Peer Reviewed Title: Pregnancy outcomes of twins after in vitro and spontaneous fertilization. Author: Choi SJ; Kim HS; Roh CR Source: International Journal of Gynecology and Obstetrics. 2006 Jul;94(1):49-51. Abstract: Multifetal pregnancy is associated with an increased risk of obstetrical complications such as: spontaneous abortion, preterm delivery, low birth weight, hypertensive disorders, gestational diabetes and placenta previa. The number and rate of multifetal pregnancy are increasing due to increased maternal age and widespread use of infertility therapy. However, there is controversy regarding pregnancy outcome of twin pregnancies after in vitro fertilization (IVF). The purpose of this study was to compare the pregnancy outcomes of spontaneously conceived twins to IVF conceived twins based on their chorionicity. (excerpt) Language: English Keywords: REPUBLIC OF KOREA | RESEARCH REPORT | RETROSPECTIVE STUDIES | IN VITRO | FERTILIZATION | PREGNANCY OUTCOMES | MULTIPLE BIRTH | Developed Countries | Asia, Eastern | Asia | Studies | Research Methodology | Clinical Research | Reproduction | Pregnancy Document Number: 302727 |
| 28. Peer Reviewed Title: Can we reduce the incidence of multiple pregnancy following ART? Author: Dastidar SG Source: Journal of the Indian Medical Association. 2006 Aug;:[2] p.. Abstract: Since the birth of Louise Brown in England using IVF technology, the procedure has been readily introduced to clinical infertility management programme throughout the world. The implantation rates of human embryo remaining relatively low, there has been a practice of replacing multiple embryos in order to increase the clinical pregnancy rate following IVF or ICSI. Consequently the fertility centres are confronted with an unacceptable level of high order multiple pregnancy. Though modern perinatal and neonatal care have improved the outcome of multiple gestations, a large share of adverse pregnancy related complications like antepartum haemorrhage, pre-eclamptic toxaemia, anaemia and polyhydramnios are associated features. Preterm and low birth weight babies, common in multiple pregnancy, are associated with incidence of handicapped children. The probability of severe handicap has been calculated to five times greater in twins than singletons, ten times in triplets and fifteen times in quadruplets. To overcome this problem, some countries have mandated the number of embryos that can be replaced, in some instances limiting this number to two in certain age groups. Such a policy of reducing the number of embryos to two, have reduced the incidence of multiple pregnancies, but simultaneously reducing pregnancy rate also. Thus, we require a reliable way of selecting embryos which have the highest potential for implantation. Such selection procedure would reduce the number of embryos needed, without compromising the final outcome. (excerpt) Language: English Keywords: INDIA | RECOMMENDATIONS | CLINICAL RESEARCH | EVALUATION INDEXES | PREGNANT WOMEN | MULTIPLE BIRTH | EMBRYO TRANSFER | PREGNANCY COMPLICATIONS | PERFORMANCE IMPROVEMENT | HEALTH STATUS INDEXES | Asia, Southern | Asia | Developing Countries | Research Methodology | Quantitative Evaluation | Evaluation | Population Characteristics | Demographic Factors | Population | Reproduction | Reproductive Technologies | Diseases | Management | Organization and Administration | Health Document Number: 307930 |
| 29. Peer Reviewed Title: [Frequency of multiple neonatal malformations in Pelotas, Rio Grande do Sul, Brazil, and associated socio-demographic factors] Frequencia das malformacoes multiplas em recem-nascidos na Cidade de Pelotas, Rio Grande do Sul, Brasil, e fatores socio-demograficos associados. Author: de Castro ML; da Cunha CD; Moreira PB; Fernandez RR; Garcias GL Source: Cadernos de Saude Publica. 2006 May;22(5):1009-1015. Abstract: This study aimed to estimate the frequency and to correlate the possible causal agents and monitor the occurrence of multiple neonatal malformations in Pelotas, Rio Grande do Sul, Brazil. The study included all births from 1990 to 2002 in the local maternity hospitals with birth weight > 500g. Each newborn presenting a malformation (case) was assigned a live matched neonate (control) without any malformation and of the same sex. A database was established by filling out the ECLAMC - MONITOR forms, 1982 edition, tabulated with SPSS. Statistical analysis used Student t and /2. During the study period, 71,500 children were born, of whom 0.11% presented multiple malformations. Significant results were found for birth weight, twin births, parents' ethnic background, paternal age, and number of previous abortions and stillbirths. In Pelotas, the proportion of newborns with malformations during the study period was 1.37%. Of these, 8.1% presented multiple malformations, predominantly in females and in births occurring during the winter. (author's) Language: Portuguese Keywords: BRAZIL | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | LONGITUDINAL STUDIES | CLINICAL RESEARCH | INFANT | BIRTH DEFECTS | LOW BIRTH WEIGHT | MULTIPLE BIRTH | ABORTION, SPONTANEOUS | FETAL DEATH | ABORTION | PREVALENCE | SEX FACTORS | SEASONAL VARIATION | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Studies | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Neonatal Diseases and Abnormalities | Diseases | Birth Weight | Body Weight | Physiology | Biology | Reproduction | Pregnancy Complications | Mortality | Population Dynamics | Fertility Control, Postconception | Family Planning | Measurement Document Number: 316645 Notification |
| 30. Peer Reviewed Title: [Neonatal mortality in Londrina, Parana State, Brazil, in 1994, 1999, and 2002] Mortalidade neonatal no Municipio de Londrina, Parana, Brasil, nos anos 1994, 1999 e 2002. Author: Ferrari LS; de Brito AS; de Carvalho AB; Gonzales MR Source: Cadernos de Saude Publica. 2006 May;22(5):1063-1071. Abstract: Despite technological progress in recent decades, neonatal mortality accounts for some two-thirds of infant deaths where the infant mortality rates are low. This study analyzes neonatal deaths in Londrina, Paraná, Brazil, during three periods, beginning with 1994, the year when pediatric and neonatal intensive care beds were created in the city. The data were collected from live birth certificates in the National Information System on Live Births (SINASC) and individual analysis of neonatal death certificates. Births declined in the city, but the low birthweight rate increased from 7.7 to 8.8% and the preterm birth rate from 6.3 to 8.4%.Multiple births also increased. Caesarian sections varied from 48 to 52%. The percentage of deaths from congenital malformations increased. The vast majority of neonatal deaths are preventable, mainly by providing specialized care during pregnancy. The neonatal mortality rate has declined recently, from 10.1 to 6.4 per 1,000 live births. The authors conclude that neonatal care is improving in Londrina. (author's) Language: Portuguese Keywords: BRAZIL | RESEARCH REPORT | LONGITUDINAL STUDIES | EPIDEMIOLOGIC METHODS | INFANT | NEONATAL MORTALITY | DEATH RECORDS | BIRTH RECORDS | PREMATURE BIRTH | CESAREAN SECTION | ANTENATAL CARE | LOW BIRTH WEIGHT | MULTIPLE BIRTH | CONGENITAL ABNORMALITIES | PREVALENCE | South America, Eastern | South America | Latin America | Americas | Developing Countries | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Infant Mortality | Mortality | Population Dynamics | Vital Statistics | Population Statistics | Pregnancy Outcomes | Pregnancy | Reproduction | Obstetrical Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Birth Weight | Body Weight | Physiology | Biology | Neonatal Diseases and Abnormalities | Diseases | Measurement Document Number: 316648 |
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