Single embryo transfer reduces the risk of perinatal mortality, a population study

Sullivan, Elizabeth A.; Wang, Yueping A.; Hayward, Irene; Chambers, Georgina M.; Illingworth, Peter; McBain, John; Norman, Robert J.
December 2012
Human Reproduction;Dec2012, Vol. 27 Issue 12, p3609
Academic Journal
STUDY QUESTION Do births following single embryo transfers (SET) have a reduced risk of perinatal mortality compared with those following double embryo transfers (DET)? SUMMARY ANSWER SET is associated with reduced risk of perinatal mortality compared with DET. WHAT IS KNOWN ALREADY Fetal, neonatal and perinatal mortality are important indicators for monitoring pregnancy and childbirth, particularly for births following assisted reproductive technology (ART) treatments. Following the introduction of SET, there has been a decline in the perinatal mortality rate (PMR) among babies born after ART in Australia and New Zealand. STUDY DESIGN, SIZE, DURATION This population study (census) included 50 258 births of ≥20 weeks gestation and/or ≥400 g of birthweight following embryos transfer cycles in Australia and New Zealand during the period 2004–2008. PARTICIPANTS/MATERIALS, SETTING, METHODS The PMR was calculated according to the number of embryos transferred and other demographic and treatment-related factors. Perinatal deaths were defined as the number of fetal deaths (stillbirths) plus the number of neonatal deaths (deaths that occur before 28 days after birth). MAIN RESULTS AND THE ROLE OF CHANCE The PMR was 16.2 per 1000 births (n= 813). Of the 813 perinatal deaths, 630 were fetal deaths and 183 neonatal deaths. Twins had a significantly higher PMR (27.8 per 1000 births) than singletons (12.4 per 1000 births). The risk of perinatal mortality for all births following DET was 53% higher than for all births following SET (adjusted risk ratio 1.53, 95% confidence interval (95% CI): 1.29–1.80). Births following fresh DET had a 58% increased risk of perinatal mortality compared with births following fresh SET (risk ratio 1.58, 95% CI: 1.32–1.90). LIMITATIONS, REASONS FOR CAUTION Information on outcomes was missing from <1% of clinical pregnancies recorded in Australian and New Zealand Assisted Reproduction Database for the study period. There are no data on the timing of fetal death, the cause of perinatal death or on late termination of pregnancy at ≥20 weeks' gestation. WIDER IMPLICATIONS OF THE FINDINGS Double and higher order embryo transfer is associated with a higher risk of perinatal mortality when compared with SET. The number of embryos transferred is determined by the clinician with consent of the patient and is a modifiable treatment factor. SET should be advocated as the first-line management in ART as it is the single most effective public health intervention for preventing excess perinatal mortality among ART pregnancies. STUDY FUNDING/COMPETING INTEREST(S) Nil.


Related Articles

  • Risk of stillbirth at extremes of birth weight between 20 to 41 weeks gestation. Ray, J G; Urquia, M L // Journal of Perinatology;Nov2012, Vol. 32 Issue 11, p829 

    Objective:To determine the risk of stillbirth between 20 to 41 weeks gestation, at highly detailed weight percentiles, including extreme degrees of small (SGA) and large (LGA) for gestational age birth weight.Study Design:We completed a population-based study of all births in Ontario, Canada...

  • Maternal Risk Factors Affecting Perinatal Mortality. Goel, Neerja; Gupta, Bindiya // Indian Pediatrics;Mar2012, Vol. 49 Issue 3, p188 

    The authors comment on a study which evaluated the clinical, behavioral and health-care associated risk factors of intrapartum perinatal mortality (IPPM). They note that the study, which came from a teaching hospital in North Indiat, reported that a large proportion of women deliver at home or...

  • Birthweight extremes = increased stillbirth risk.  // Contemporary OB/GYN;Jul2012, Vol. 57 Issue 7, p12 

    The article offers scientific news brief as of July 2012, on association of birth weight extremes on both ends of the spectrum with increasing risk of stillbirth and intrauterine death.

  • Risk factors for perinatal death in two different levels of care: a case-control study. Soares Moura, Paula Maria Silveira; Maestá, Izildinha; Suppo Rugolo, Lígia Maria Souza; Berbel Angulski, Luís Felipe Ramos; Caldeira, Antônio Prates; Peraçoli, José Carlos; Rudge, Marilza Vieira Cunha // Reproductive Health;2014, Vol. 11 Issue 1, p1 

    Background According to the World Health Organization, there are over 6.3 million perinatal deaths (PND) a year worldwide. Identifying the factors associated with PND is very helpful in building strategies to improve the care provided to mothers and their babies. Objective To investigate the...

  • Breech babies have higher risk of death following vaginal birth than caesarean.  // British Journal of Hospital Medicine (17508460);Sep2014, Vol. 75 Issue 9, p489 

    No abstract available.

  • Vaccination against pandemic A/H1N1 2009 influenza in pregnancy and risk of fetal death: cohort study in Denmark. Pasternak, Bjrn; Svanstrm, Henrik; Mlgaard-Nielsen, Ditte; Krause, Tyra G; Emborg, Hanne-Dorthe; Melbye, Mads; Hviid, Anders // BMJ: British Medical Journal (Overseas & Retired Doctors Edition;5/19/2012, Vol. 344 Issue 7857, p17 

    The article presents a study on the association of increased risk of fetal death with exposure to an adjuvanted pandemic A/H1N1 2009 influenza vaccine in pregnancy in Denmark. The study made used of the cox regression to estimate the hazard ratios of fetal death. The result of the study shows...

  • Impact of elevated peak serum estradiol levels during controlled ovarian hyperstimulation on the birth weight of term singletons from fresh IVF-ET cycles. Pereira, Nigel; Reichman, David; Goldschlag, Dan; Lekovich, Jovana; Rosenwaks, Zev // Journal of Assisted Reproduction & Genetics;Apr2015, Vol. 32 Issue 4, p527 

    Purpose: To investigate the impact of elevated serum estradiol (E) levels on the day of hCG trigger on the birth weight of term singletons after fresh In Vitro Fertilization (IVF)-Embryo Transfer (ET) cycles. Methods: Retrospective cohort study of all patients initiating fresh IVF-ET cycles...

  • Neonatal Mortality and Perinatal Risk Factors in Rural Southwestern Nigeria: A Community-Based Prospective Study. Lawoyin, T. O.; Onadeko, M. O.; Asekun-Olarinmoye, E. O. // West African Journal of Medicine;Jan/Feb2010, Vol. 29 Issue 1, p19 

    No abstract available.

  • Sleep Positions Can Predict Women's Risk of Stillbirth. Hsu, Christine // Inside Childbirth Education;April2013, p9 

    The article focuses on a new study by the University of Michigan in Ghana which shows higher risk of stillbirth in women if they sleep on their back during pregnancy and give birth to a baby of low birth weight. Researchers of the study states that sleeping on the back during pregnancy causes...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics