The Impact Of Multiple Pregnancy Reduction On Obstetric Outcome And Children Cognition After Assisted Reproductive Technology

Objective:Discuss the impact of multiple pregnancy reduction on pregnancy complication, obstetric outcomes and the neonate birth weight and neuropsychological development after assisted reproductive thchnology (ART)Methods:Select561multiple pregnancy reduction after ART during April2004to September2011,181multiple pregnancy reduction to single (selective reduction106cases, spontaneous reduction75cases),380multiple pregnancy reduction to twins (selective reduction371cases, spontaneous reduction9cases), and with the same period357primary single pregnancy and383primary twins pregnancy, compare each group’s abortion, premature delivery and neonate birth weight.Select130multiple pregnancy reduction,82multiple pregnancy reduction to single (selective reduction7cases, spontaneous reduction75cases),48multiple pregnancy reduction to twins (selective reduction39cases, spontaneous reduction9cases), and with the same period108primary single pregnancy and52primary twins pregnancy, compare each group’s geststional hypertension, geststional diabetes mellitus (GDM), placenta previa, obstetris complications, ovarian hyperstimulation syndrome, and neuropsychological development.Results:(1)Average maternal ages and pregnancy complication:no statistical significance (P>0.05)(2) Obstetric outcomes:The abortion rate of triplets reducts to single is more than twins reducts to single, there was statistical significance(P=0.028).The abortion rate of≥quintuplet and quadruplets reducts to twins is more than primary twins, there was statistical significance(P<0.05). The abortion rate of quadruplets reducts to twins is more than triplets reducts to twins, there was statistical significance(P=0.016); The preterm delivery rate of multiple pregnancy reducts to single was higher than primary single, there was statistical significance(P=0.001); The preterm delivery rate of multiple pregnancy reducts to twins was higher than multiple pregnancy reducts to single, there was statistical significance(P=0.000); The preterm delivery rate of primary twins was higher than twins reducts to single, there was statistical significance(P=0.000) The mean gestational ages at delivery of primary single was higher than multiple pregnancy reducts to single, there was statistical significance(P=0.001); The mean gestational ages at delivery of multiple pregnancy reducts to single was higher than multiple pregnancy reducts to twins, there was statistical significance(P=0.000); The mean gestational ages at delivery of twins reducts to single was higher than primary twins, there was statistical significance(P=0.000).(3) The neonate birth weight:The average birth weight of multiple pregnancy reduction to single was higher than multiple pregnancy reduction to twins, there was statistical significance(P=0.000); The average birth weight of multiple pregnancy reduction to single was lower than primary single, there was statistical significance(P=0.001); The average birth weight of twins reduction to single was higher than primary twins,there was statistical significance(P=0.000); The average birth weight of multiple pregnancy reduction to twins was lower than primary twins,there was statistical significance(P=0.001); The low birth weight rate of multiple pregnancy reduction to single was more than primary single, there was statistical significance(P=0.000); The low birth weight rate of multiple pregnancy reduction to single was lower than multiple pregnancy reduction to twins, there was statistical significance(P=0.000); The low birth weight rate of twins reduction to single was lower than primary twins, there was statistical significance(P=0.000); The low birth weight rate of multiple pregnancy reduction to single was lower than primary twins, there was statistical significance(P=0.002); The low birth weight rate of≥quintuplet、 quadruplets and triplets reduction to twins has statistical significance(P<0.05).(4) Neurodevelopment and mental development:①In the language points, operating points and total points, the average IQ of multiple pregnancy reduction was lower than primary, there was statistical significance(P<0.05);②In linguistic intelligence distributioin, operation distribution and total distributioin, multiple pregnancy reduction with primary, there was statistical significance(P<0.05).Conclusion:(1) Multiple pregnancy reduction is a secure, reliable method.There was no significant difference in the obstetric outcomes of selective reduction with spontaneous reduction.And it can improve the outcome of pregnancy, reduce the preterm delivery rate, length gestational age, increase the average birth weight and reduce the low birth weight rate.(2) There was no significant difference in pregnancy complication after multiple pregnancy reduction with primary single or twins;(3) The obstetric outcomes of multiple pregnancy reducts to single is better than multiple pregnancy reducts to twins(4) The obstetric outcomes of multiple pregnancy reducts to single or twins is worse than primary single or twins;(5) There is a negative correlation between the abortion rate、the low birth weight rate with the primary number of fetal;(6) In the language points、operating points、total points, multiple pregnancy reduction to twins or single was lower than primary twins or single.