Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education;Chengdu, P.R. China.
J Perinat Med. 2020 Sep 25;48(7):639-647. doi: 10.1515/jpm-2020-0088.
Objectives To compare the fetal and maternal outcomes in surviving singletons of vanishing twin, with singletons or twins, in pregnancies following assisted reproductive technology (ART). Content We searched the PubMed, Embase, Web of Science and Cochrane databases from the time of conception of the database until Dec 2019 to identify relevant published studies. Perinatal outcomes were synthesized with random effects meta-analysis using RevMan 5.3. Summary and Outlook Fifteen studies were included. Dichorionic twin pregnancies conceived by ART wherein the vanishing twin phenomenon occurred had a risk of fetal malformation similar to that of ART singleton pregnancies (OR=1.25; 95% CI 0.87-1.79) and a higher risk of fetal malformation compared with ART twin pregnancies (OR=1.82; 95% CI 1.23-2.70). Moreover, the remaining fetus in ART vanishing twin pregnancy was at a significantly higher risk of preterm birth (<37 weeks) compared to fetuses in ART singleton pregnancies (OR=2.41; 95% CI 1.46-3.99) and a markedly lower risk of preterm birth (<37 weeks) compared to the fetuses in ART twin pregnancies (OR=0.19; 95% CI 0.16-0.22). Meanwhile, the risk of delivery of infants who were small for gestational age (SGA) was significantly higher in ART vanishing twin pregnancies compared to that in ART singleton pregnancies (OR=2.70; 95% CI 1.39-5.24) and similar to that in ART twin pregnancies (OR=0.67; 95% CI 0.27-1.65). The risks of preterm birth and of the infant being SGA is higher for the remaining fetus in an ART vanishing twin pregnancy compared to those for the fetuses in ART singleton pregnancies; the risk of fetal malformation is also higher in such cases compared with ART twin pregnancies.
目的 比较辅助生殖技术（ART）后消失的单卵双胎妊娠与单胎或双胎妊娠的存活单胎胎儿和产妇结局。
内容 我们检索了从数据库建立开始至 2019 年 12 月的 PubMed、Embase、Web of Science 和 Cochrane 数据库，以确定相关的已发表研究。使用 RevMan 5.3 进行随机效应荟萃分析综合围产儿结局。
总结和展望 纳入了 15 项研究。ART 双绒毛膜双胞胎妊娠中发生消失的双胞胎现象，其胎儿畸形风险与 ART 单胎妊娠相似（OR=1.25；95%CI 0.87-1.79），且与 ART 双胎妊娠相比，胎儿畸形风险更高（OR=1.82；95%CI 1.23-2.70）。此外，ART 消失的双胞胎妊娠中剩余的胎儿早产（<37 周）的风险明显高于 ART 单胎妊娠（OR=2.41；95%CI 1.46-3.99），且早产（<37 周）的风险明显低于 ART 双胎妊娠（OR=0.19；95%CI 0.16-0.22）。同时，ART 消失的双胞胎妊娠中小于胎龄儿（SGA）的分娩风险明显高于 ART 单胎妊娠（OR=2.70；95%CI 1.39-5.24），与 ART 双胎妊娠相似（OR=0.67；95%CI 0.27-1.65）。与 ART 单胎妊娠相比，ART 消失的双胞胎妊娠中剩余胎儿早产和 SGA 的风险更高，而胎儿畸形的风险也更高。
