Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Multiple Birth”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 811 records · Page 45Linked to original sources
PubMed1995

A reexamination of the risk factors for the sudden infant death syndrome.

OBJECTIVE: To determine which risk factors are specific for the sudden infant death syndrome (SIDS) rather than characteristic of postneonatal deaths in general. STUDY POPULATION: The live births and infant death cohorts of the 1988 National Maternal and Infant Health Survey. METHODS: Information on live births, deaths from SIDS, and postneonatal deaths from other causes was abstracted from the National Maternal and Infant Health Survey. To account for oversampling of certain populations, the data were weighted to reflect national counts. Risk factors were defined as black race, birth weight less than 1500 gm, birth weight less than 2500 gm, gestational age at birth less than 37 weeks, 5-minute Apgar score less than 7, male gender, more than two previous pregnancies, maternal age less than 20 years, maternal education level less than 12 years, multiple births, and maternal smoking during pregnancy. Odds ratios (ORs) and 95% confidence intervals (Cls) were calculated to compare the SIDS with the live births cohort, infants who died of other causes with the live births cohort, and SIDS with non-SIDS deaths. The population-attributable risk percentage was computed for risk factors independently associated with SIDS when compared with other postneonatal deaths. RESULTS: For all characteristics other than a 5-minute Apgar score less than 7, the ORs comparing infants who died of SIDS with the live births cohort were significantly greater than 1.0. Similarly, ORs comparing infants who died of other causes with the live births cohort were also greater than 1.0, except for male gender. When the two infant death cohorts were compared, only maternal smoking during pregnancy and low maternal education level were significantly more common among the SIDS group. After we controlled for cigarette smoking, the adjusted OR for low maternal education level was not significantly greater than 1.0. However, even after control for low maternal education level, prenatal exposure to tobacco was significantly more common among the SIDS group than in infants dying of other causes (OR = 1.97; 95% Cl, 1.59 to 2.45). On the basis of an adjusted OR of 2.92 when the SIDS group was compared with the live births cohort, the population-attributable risk percentage for maternal smoking as a risk factor for SIDS was 30%. CONCLUSION: Among characteristics generally thought to be risk factors, only maternal smoking during pregnancy was independently associated with SIDS. Data from this nationally representative sample indicate that if women refrained from smoking while pregnant, up to 30% of SIDS might be prevented.

Apgar Score↗
PubMed2000

The economic consequences of multiple gestation pregnancy in assisted conception cycles.

This study estimates the projected costs of multiple births resulting from assisted conception cycles (in vitro fertilization with or without intracytoplasmic sperm injection and ovarian stimulation with gonadotrophin). The estimates are modelled from the volume of services, treatment success and multiple gestation rates in recent registry data. The coverage is restricted to hospital costs associated with delivery and the trends are projected to 2000 in the United States. Sensitivity analyses tested different assumptions about per annum trends in effectiveness, multiple pregnancy rates and health costs. The national cost of in vitro fertilization cycles is US$470.2 million (£313.5 million) and the cost of the multiple pregnancies from in vitro fertilization is US$639.9 million (£426.7 million). The national cost of ovarian stimulation cycles is US$166.6 million (£111.1 million) and the cost of the multiple pregnancies from ovarian stimulation is US$257.3 million (£171.6 million). Although costs are a limited indicator of the burden of illness, the projected national cost of multiple pregnancy associated with assisted conception in 2000 is greater than the base cost of the treatment. Prevention of multiple pregnancy in assisted conception cycles should be a priority.

Journal Article↗
PubMed2005

Explaining the 2001-2002 infant mortality increase in the United States: data from the linked birth/infant death data set.

The U.S. infant mortality rate (IMR) increased from 6.8 infant deaths per 1,000 live births in 2001 to 7.0 in 2002, the first increase in more than 40 years. From 2001 to 2002, IMR increased for very low birthweight infants as well as for preterm and very preterm infants. Although IMR for very low birthweight infants increased, most of the increase in IMR from 2001 to 2002 was due to a change in the distribution of births by birthweight and, more specifically, to an increase in infants born weighing less than 750 grams. The majority of infants born at less than 750 grams die within the first year of life; thus, these births contribute disproportionately to overall IMR. Increases in births at less than 750 grams occurred fornon-Hispanic white, non-Hispanic black, and Hispanic women. Most of the increase occurred among mothers 20 to 34 years of age. Although multiple births contributed disproportionately, most of the increase in births at less than 750 grams occurred among singletons. Three hypotheses were evaluated to assess their possible impact on the increase in less than 750-gram births: possible changes in (1) the reporting of births or fetal deaths, (2) the risk profile of births, and (3) medical management of pregnancy. Although each of these factors may have contributed to the increase, the relative effects of these and other factors remain unclear. More detailed studies are needed to further explain the 2001-2002 infant mortality increase.

Birth Rate↗
PubMed2005

Explaining the 2001-02 infant mortality increase: data from the linked birth/infant death data set.

The U.S. infant mortality rate increased from 6.8 infant deaths per 1,000 live births in 2001 to 7.0 in 2002, the first increase in more than 40 years. From 2001 to 2002 infant mortality rates increased for very low birthweight infants as well as for preterm and very preterm infants. Although infant mortality rates for very low birthweight infants increased, most of the increase in the infant mortality rate from 2001 to 2002 was due to a change in the distribution of births by birthweight and, more specifically, to an increase in infants born weighing less than 750 grams (1 lb 10 1/2 oz). The majority of infants born weighing less than 750 grams die within the first year of life; thus, these births contribute disproportionately to the overall infant mortality rate. Increases in births at less than 750 grams occurred for non-Hispanic white, non-Hispanic black, and Hispanic women. Most of the increase occurred among mothers 20-34 years of age. Although multiple births contributed disproportionately, most of the increase in births at less than 750 grams occurred among singletons. Three hypotheses were evaluated to assess their possible impact on the increase in less than 750-gram births: first, possible changes in the reporting of births or fetal deaths; second, possible changes in the risk profile of births; and third, possible changes in medical management of pregnancy. Although each of these factors may have contributed to the increase, the relative effects of these and other factors remain unclear. More-detailed studies are needed to further explain the 2001-02 infant mortality increase.

Birth Weight↗
PubMedDate not supplied

[Can the indications for the presence of the neonatal emergency service be determined before the onset of labor?].

The purpose of this study was to recommend guidelines for the consultation of the Neonatal Emergency Service when birth risks appear. Data from 39.479 births in 20 obstetric clinics and 1.723 emergency transports to the same clinics during the period 1979-1981 were analysed. The criteria applied for neonatal distress were necessity of resuscitation measures in the delivery room and perinatal mortality. It is recommended that the Neonatal Emergency Service should be called in before birth in the following cases: all premature births up to 34 weeks of gestation; from 35 to 37 weeks in case of additional risk factors; from 38th week onward in case of intrapartum bleeding, umbilical cord prolapse or tear, multiple births, transverse or face presentations and continuous heart rate deceleration.

Asphyxia Neonatorum↗
PubMed1993

Controlled studies of multivitamin supplementation on pregnancy outcomes.

The Hungarian Family Planning Program includes a randomized prospective blind study of periconceptional multivitamin and trace element supplementation to test the efficacy of this treatment in the reduction of the first occurrence of neural tube defect. This program is appropriate for the evaluation of pregnancy outcomes in general. Periconceptional multivitamin supplementation had no beneficial effect on fetal death, that is, chemical and ectopic pregnancies, missed miscarriages, miscarriages, and stillbirths. The proportion of low birth weight (5.8%) was higher in the combined vitamin I-II sample than in the combined trace element I-II sample (4.3%), but it was explained by a higher rate of multiple births in the vitamin sample. The estimated rate of monozygotic twins was higher after periconceptional multivitamin supplementation. The number of informative pregnancies using vitamin and trace elements was 2104 and 2052, respectively. The rate of cases with congenital abnormality was significantly higher in the total trace element sample (22.4 per 1000) than in the total vitamin sample (13.3 per 1000).

Adult↗
PubMed2004

Health care costs resulting from IVF: prenatal and neonatal periods.

BACKGROUND: The use of expensive infertility treatments is increasing rapidly. To compare the prenatal and neonatal health care costs after IVF and spontaneous conception, we conducted a study based on a cohort of IVF and control pregnancies and neonates. METHODS: A cohort of 215 IVF mothers and 255 IVF neonates were compared with a cohort of 662 control mothers and 388 control children, randomly chosen from the Finnish Medical Birth Register and matched for sex, year of birth, area of residence, parity, maternal age, socioeconomic status and plurality. The analyses on prenatal and neonatal costs were performed by plurality. Singletons were also compared with twins. The cost calculations were based on the known level of utilization of maternal and neonatal health care services. RESULTS: The total health care costs for an IVF singleton until the end of the neonatal period were 5780 and 15 580 for an IVF twin. The health care costs were 1.3-fold for IVF singletons and 1.1-fold for IVF twins compared to control singletons and twins. The costs for twins were approximately 3-fold compared to singletons. CONCLUSIONS: The health care costs of an IVF singleton neonate were higher than those of a spontaneously conceived control neonate with similar backgrounds. For twins the health care costs were equal. Multiple births increase the health care costs and therefore the reduction of multiple pregnancies is the most effective way to reduce the health care costs resulting from IVF.

Abortion, Spontaneous↗
PubMed1996

[Epidemiological study of intestinal atresias: central-eastern France Registry 1976-1992].

OBJECTIVE: Our purpose was to describe the epidemiology of small intestinal atresia. STUDY DESIGN: We used data collected by the Central-East France Congenital Malformations Registry from 1976 through 1992 to evaluate the prevalence of different types of intestinal atresia in liveborn and stillborn infants and to study some demographic and clinical features such as sex ratio, multiple births, gestational age, birth weight, maternal age, maternal disease, associated malformations. RESULTS: Through surveillance of more than 1.5 million births, we identified 344 liveborn and 14 stillborn infants with intestinal atresia (1A). The prevalence of 1A was 2.25 per 10,000 livebirths. Fifty percent of the liveborn infants had duodenal atresia, 36% had jejunoileal atresia, 7% had colic atresia, 3% had intestinal duplication and 5% had multiple atresia. The twinning rate was 4.4% which is significantly higher than in the non malformed population. Gestational age was less than 37 weeks in 35.4% of the cases. Birth weight was less than 2,500 g in 52% of the cases. For those two variables we observed significant differences among the different types of malformations. Study of 1A rates by maternal age showed an increased risk below the age of 20 (p < 10(-5)). We didn't find significant differences compared to the population for ovulation induction and maternal diabetes. Study of associated malformations demonstrated significant differences in rates and types of associated malformations in the different groups of 1A which suggests heterogenous embryological mechanisms. CONCLUSION: These findings confirm the literature data for most of the epidemiological characteristics. Only the association of an increased risk in the teenage mothers group was not previously described. This finding has to be confirmed by others studies.

Abortion, Therapeutic↗
PubMedDate not supplied

Seasonality of birth and conception to teenagers in Texas.

We study the births to teenagers during the years 1964-2000 and analyze separately the three main racial/ethnic groups in Texas (White, Hispanic, and African American), as well as married and unmarried teens during the years 1994-2000. By using traditional statistical methods of analysis and a filter based on the multiresolution wavelet analysis, we draw inferences about the times of the year when adolescent females of different racial/ethnic and marital groups have the highest probability for pregnancy ending in live birth. Multiple factors influencing teen pregnancy are identified and associated with temporal features of social, cultural, educational, and familial processes. In particular, we detect links between unmarried teen conception times and school terms, and weekly birth patterns associated with scheduled c-sections that differ according to racial/ethnic groups.

Adolescent↗
PubMed2000

Incidence of congenital malformations in children born after ICSI.

The aim of this study was to determine the incidence of congenital malformations in a complete cohort of children born after intracytoplasmic sperm injection (ICSI). The medical records were retrieved for 1139 infants, 736 singletons, 200 sets of twins and one set of triplets. The total number of infants with an identified anomaly was 87 (7.6%), 40 of which were minor. The incidence of malformations in children born after ICSI was also compared with all births in Sweden using data from the Swedish Medical Birth Registry and the Registry of Congenital Malformations. For ICSI children, the odds ratio (OR) for having any major or minor malformation was 1.75 [95% confidence interval (CI) 1.19-2.58] after stratification for delivery hospital, year of birth and maternal age. If stratification for singletons/twins was also done, the OR was reduced to 1.19 (95% CI 0.79-1.81). The increased rate of congenital malformations is thus mainly a result of a high rate of multiple births. The only specific malformation which was found to occur in excess in children born after ICSI was hypospadias (relative risk 3.0, exact 95% CI 1. 09-6.50) which may be related to paternal subfertility.

Chromosome Aberrations↗
PubMed1995

Pregnancies and births resulting from in vitro fertilization: French national registry, analysis of data 1986 to 1990. FIVNAT (French In Vitro National).

OBJECTIVE: To describe the characteristics of pregnancies and children at birth resulting from IVF-ET and to assess whether they differ from those after natural conception. DESIGN: Prospective multicenter survey. SETTING: A national registry, representing 80% of all French IVF-ET activity for the period 1986 to 1990. PATIENTS: Data on 7,024 pregnancies, 5,371 deliveries, and 6,879 newborn infants. INTERVENTIONS: A form is completed for every clinical pregnancy. MAIN OUTCOME MEASURES: Spontaneous abortion, ectopic pregnancy, multiple pregnancy, prematurity, hypotrophy, perinatal and neonatal mortality, and congenital malformations rates. RESULTS: The spontaneous abortion and ectopic pregnancy rates were, respectively, 17.6% and 5.8%. More than a quarter (26.8%) of the deliveries were multiple births. The preterm birth rate (29.3%), the low birth weight rate (36.2%), and the perinatal and neonatal mortality rates were higher than the national average. The rate of malformations (2.8%) was comparable with the general population (2.1%). CONCLUSION: Assisted conception frequently results in multiple pregnancy, and this is the main determinant of pregnancy outcome. Nevertheless, it is not the only risk factor for prematurity, which is also more frequent among IVF singleton newborn. The prevalence of congenital malformations is not higher than after natural conception.

Birth Rate↗
PubMed2005

[Can data from quality assurance programs such as peri-/neonatal compilations be used for secondary epidemiological studies?].

BACKGROUND: The aim of this study was to explore whether population-based data from a regional quality control program can be utilized to compare the neonatal outcome of small for gestational age (SGA) and appropriate size for gestational age (AGA) new-borns. METHODS: The Center for Quality Management in Health Care maintains perinatal data for almost all births in Lower Saxony (Germany). Neonatal data are collected for all infants admitted to hospital within 10 postnatal days. We evaluated linked perinatal and neonatal datasets of 4126 very low birthweight infants (VLBW; < 1500 g), born in 1991 - 1996. After checking for completeness, representativeness, and validity, exclusion criteria were defined to minimize bias and to yield similar proportions of SGA- and AGA-neonates. Since inclusion of all multiple births would lead to an overestimation of maternal risk factors, one sibling was randomly selected from each set of multiples. Bias arising from not well defined study populations should be shown based on univariable mortality analyses (Kaplan-Meier survival curves). RESULTS: Application of exclusion criteria resulted in a final study population of 1623 independent (disjunctive) new-borns from 25 - 29 weeks gestation, 173 of whom were SGA, 1450 AGA. Kaplan-Meier curves from the initial study population and the well defined study base differed significantly. Trend analysis revealed a significant (p < 0.05) increase in proportions of both VLBW (from 0.95 % in 1991 to 1.11 % in 1996; + 17 %) and SGA infants (from 22.7 % to 27.4 %; + 21 %) within the observational period. A well defined data selection process is necessary if data collected for other purposes are to be used for epidemiological studies. Neglecting this labour-intensive work may be one reason for the varying results on the outcome of SGA and AGA infants.

Bias↗
PubMed1999

Delivery outcome after the use of antidepressants in early pregnancy.

OBJECTIVES: To investigate delivery outcome after the use of antidepressants in early pregnancy. METHODS: Using an ongoing prospective recording of drug use in early pregnancy, 969 women were identified who reported the use of antidepressants: 531 used only SSRI (selective serotonin re-uptake inhibitor) drugs (mostly citalopram, 375 exposures), 423 used only other antidepressants, and 15 used both. Outcome was compared with all births in the population. RESULTS: Women using these drugs were older and smoked more than three times as often as other women. There seemed to be an excess of high parity women. The frequency of multiple births was lower than expected, resulting from too few twin births in women who had used SSRI. Gestational duration among singletons was shorter but it did not affect infant survival and was similar after the use of SSRI or non-SSRI antidepressants, perhaps the result of uncompensated for confounding or related to the underlying disease. Infants were somewhat heavier than expected, notably after non-SSRI treatment. No increase was seen in congenital abnormalities, observable in the perinatal period. CONCLUSIONS: Based on this database, the use of antidepressants in early pregnancy does not seem to carry any significant risk for the infant that is detectable during the newborn period.

Adolescent↗
PubMed1996

Effect of maternal age and parity on the risk of uteroplacental bleeding disorders in pregnancy.

OBJECTIVE: To examine the risk of placental abruption, placenta previa, and uterine bleeding of unknown etiology in relation to advanced maternal age and parity in a large, population-based study. METHODS: Data for this study were derived from the Nova Scotia Atlee perinatal provincial data base, Canada, an ongoing project on human reproduction. Women who delivered between 1980 and 1993 (n = 123,941) in the province of Nova Scotia were included in the study, with the exception of pregnancies resulting in multiple births (n = 2859) and those missing data on maternal age or parity (n = 14). Multivariable logistic regression models based on the method of generalized estimating equations were used to generate odds ratios after adjustment for multiple confounders. RESULTS: The frequency of abruption was increased slightly among younger women (relative risk [RR] 1.3, 95% confidence interval [CI] 1.0-1.7), compared with women ages 25-29 years, but there was no increase with advancing maternal age. In contrast, the risk of placenta previa increased dramatically with advancing maternal age, with women older than 40 years having a nearly ninefold greater risk than women under the age of 20, after adjustment for potential confounders, including parity. Uterine bleeding of unknown etiology was not associated with advanced maternal age, except for a slight increase among women over 40 (RR 1.3, 95% CI 1.0-1.6). The risk of placenta previa and placental abruption was increased with higher parity among younger women only, but uterine bleeding of unknown etiology was more weakly associated with higher parity. In addition, an analysis of the joint effects of age and parity on placental abruption indicated a strong parity effect for women under 30 years, whereas the risk of placenta previa increased with increasing parity up to age 35 years. Uterine bleeding of unknown etiology also indicated a parity effect that was restricted to women under 25 years. CONCLUSION: Multiparity is associated with the risk of placenta previa and, to a lesser extent, placental abruption, but not with other uterine bleeding. Increasing maternal age is associated independently with the risk of placenta previa, but not with either of the other two conditions. Finally, the increased risks of uteroplacental bleeding disorders with advanced parity among the younger women (ie, 20-25 years, parity 3+) may reflect effects of close pregnancy spacing, or confounding by unmeasured factors that characterize women who have many pregnancies at a relatively young age. Overall, the findings suggest that the three uteroplacental bleeding disorders do not share a common etiology in relation to maternal age and parity, and that placenta previa is linked to aging of the uterus and the effects of repeated pregnancies.

Abruptio Placentae↗
PubMed1994

Differences between black and white women in the use of prenatal care technologies.

OBJECTIVE: The purpose of this study was to determine whether the content of prenatal care received by black and white women in the United States differs, as measured by the use of amniocentesis, ultrasonography, and tocolysis. STUDY DESIGN: This study uses data from birth certificates issued for births occurring in the United States in 1990. Multivariate analyses were used to calculate the relative risk of receipt of each technology by black women compared with white women. RESULTS: Amniocentesis was used substantially less frequently by black women (relative risk 0.6), whereas ultrasonography was received by black women slightly less frequently than white women (relative risk 0.9). Tocolysis used varied by plurality. Black women with singleton births were slightly more likely to receive tocolysis than were white women (relative risk 1.1), although the risk of idiopathic preterm delivery is estimated to be three times higher in black women. Black women with multiple births received tocolysis two thirds as often as white women. CONCLUSIONS: These results suggest that differences exist in the content of prenatal care received by black and white women in the United States. This finding should be followed up with more detailed studies to identify its cause and possible interventions.

Adult↗
PubMed2005

In vitro fertilization (IVF) in Sweden: risk for congenital malformations after different IVF methods.

BACKGROUND: The possible excess of congenital malformations in infants born after in vitro fertilization (IVF) has been much discussed in the literature, with controversial conclusions. This population based study is aimed at analyzing the presence of congenital malformations in a large group of infants born after IVF and to compare malformation risk both with that of all infants born and according to IVF method used. METHODS: Infants born after IVF during the period 1982-2001 were ascertained from all IVF clinics in Sweden. The presence of congenital malformations was identified from three national health registers: the Swedish Medical Birth Register, the Swedish Registry of Congenital Malformations, and the Swedish Hospital Discharge Register. The IVF children were compared with all children born in Sweden during the same period and recorded in the Swedish Medical Birth Register. RESULTS: Among 16,280 IVF children (30% conceived after intracytoplasmatic sperm injection [ICSI]) a 42% excess of any congenital malformation was found, explainable by parental characteristics and in some cases by the high rate of multiple births. Among these children, 8% had a congenital malformation, and 5% had a relatively severe condition. For neural tube defects, choanal atresia, and alimentary tract atresia, an additional risk increase was seen. There was no difference in malformation rate according to IVF method except for an excess of hypospadias after ICSI. CONCLUSIONS: An increased risk for congenital malformations occurs after IVF, similar for the different IVF techniques used, and mainly a consequence of parental characteristics. A few specific conditions show an extra increase in risk.

Congenital Abnormalities↗
PubMed1999

Epidemiology of SIDS and explained sudden infant deaths. CESDI SUDI Research Group.

OBJECTIVES: To establish whether epidemiologic characteristics for sudden infant death syndrome (SIDS) have changed since the decrease in death rate after the "Back to Sleep" campaign in 1991, and to compare these characteristics with sudden and unexpected deaths in infancy (SUDI) from explained causes. DESIGN: Three-year, population-based, case-control study. Parental interviews were conducted soon after the death and for 4 controls matched for age and date of interview. All sudden unexpected deaths were included in the study and the cause of death was established by a multidisciplinary panel of the relevant health care professionals taking into account past medical and social history of the mother and infant, the circumstances of death, and a full pediatric postmortem examination. Contributory factors and the final classification of death were made using the Avon clinicopathologic system. SETTING: Five regions in England, with a total population of >17 million people, took part in the study. The number of live births within these regions during the particular time each region was involved in the study was 473 000. STUDY PARTICIPANTS: Three hundred twenty-five SIDS infants (91.3% of those available), 72 explained SUDI infants (86.7% of those available), and 1588 matched control infants (100% of total for cases included). RESULTS: Many of the epidemiologic features that characterize SIDS infants and families have remained the same, despite the recent decrease in SIDS incidence in the United Kingdom. These include the same characteristic age distribution, few deaths in the first few weeks of life or after 6 months, with a peak between 4 and 16 weeks, a higher incidence in males, lower birth weight, shorter gestation, and more neonatal problems at delivery. As in previous studies there was a strong correlation with young maternal age and higher parity and the risk increased for infants of single mothers and for multiple births. A small but significant proportion of index mothers had also experienced a previous stillbirth or infant death. The majority of the SIDS deaths (83%) occurred during the night sleep and there was no particular day of the week on which a significantly higher proportion of deaths occurred. Major epidemiologic features to change since the decrease in SIDS rate include a reduction in the previous high winter peaks of death and a shift of SIDS families to the more deprived social grouping. Just more than one quarter of the SIDS deaths (27%) occurred in the 3 winter months (December through February) in the 3 years of this study. In half of the SIDS families (49%), the lone parent or both parents were unemployed compared with less than a fifth of control families (18%). This difference was not explained by an excess of single mothers in the index group. Many of the significant factors relating to the SIDS infants and families that distinguish them from the normal population did not distinguish between SIDS and explained SUDI. In the univariate analysis many of the epidemiologic characteristics significant among the SIDS group were also identified and in the same direction among the infants dying as SUDI attributable to known causes. The explained deaths were similarly characterized by the same infant, maternal, and social factors, 48% of these families received no waged income. Using logistic regression to make a direct comparison between the two index groups there were only three significant differences between the two groups of deaths: 1) a different age distribution, the age distribution of the explained deaths peaked in the first 2 months and was more uniform thereafter; 2) more congenital anomalies were noted at birth (odds ratio [OR] = 3.14; 95% confidence intervals [CI]: 1.52-6. (ABSTRACT TRUNCATED)

Age Distribution↗
PubMedDate not supplied

The journey from infertility to parenting multiples: a dream come true?

Infertility deeply affects psychosocial aspects of young couples, who often erroneously take fertility for granted. The inevitable transformation from apparently healthy adults into patients can lead to loss of self-esteem, confidence, health, close relationships, security, and hope. Frequently, when emotional and psychological resources are diminished after prolonged infertility, the couple may express their desperate wish for a family in the form of accepting without reservation the risks of a multiple pregnancy, ignoring the undeniable increased morbidity and mortality associated with these gestations. It is unclear why a couple embarking on the journey of infertility treatment may prefer a pregnancy that is tenfold as likely to have a serious adverse outcome. Of the three potential explanations for such an attitude--desperation, denial, and ignorance--only the last one can be solved with patient education and adequate counseling. At the same time, it is unjustified to avoid assisted reproductive technologies because of potential adverse outcome, however necessary it is to acknowledge the risk of multiple births.

Adult↗