Fetal Reduction in Multifetal Pregnancies Results in Fewer Preterm Births and Deaths

MedicalResearch.com Interview with:

Neda Razaz, PhD, MPH Postdoctoral Fellow Reproductive Epidemiology Unit Karolinska Institutet

Dr. Razaz

Neda Razaz, PhD, MPH
Postdoctoral Fellow
Reproductive Epidemiology Unit
Karolinska Institutet

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Multiple births of twins and triplets – and the associated health risks – have increased in many high-income countries, with a respective two-fold and three-fold increase in recent decades.

In Canada, triplet births or higher have increased from 52.2 per 100 000 live births to 83.5 between 1991 and 2009, mainly because of an increase in fertility treatments for older women of child-bearing age. In this study we found that among twin and triplet pregnancies that were reduced to singleton or twin pregnancies, there was a substantial reduction in complications such as preterm birth and very preterm birth. Although rates of death and serious illness were not lower among all multifetal pregnancies that were reduced, pregnancies that resulted from fertility treatments did show a significant reduction in rates of death or serious illness following fetal reduction.

MedicalResearch.com: What should readers take away from your report?

Response: The fetal reduction-associated decrease in preterm birth and low birth weight overall, combined with the decrease in death and serious illness among babies of women who conceived following fertility treatments, suggests that fetal reduction in multifetal pregnancy offers substantial benefits.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: Future studies should examine how the timing, reason and number of fetuses reduced in some pregnancies might influence perinatal outcomes.

MedicalResearch.com: Is there anything else you would like to add?

Response: Physicians need to be sensitive when discussing the risks and benefits of fetal reduction with parents. Clinicians counseling women with multifetal pregnancy should be aware of the potential for substantial parental stress resulting from fetal reduction procedures, including negative feelings such as guilt, regret and grief.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:
Neda Razaz, Tehila Avitan, Joseph Ting, Tracy Pressey, and K.S. Joseph
Perinatal outcomes in multifetal pregnancy following fetal reduction
CMAJ May 8, 2017 189:E652-E658; doi:10.1503/cmaj.160722

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