Surgical twin reduction associated with higher adverse outcomes compared to vanishing twin syndrome in a retrospective cohort.
This retrospective cohort study analyzed data from 1,796 patients diagnosed with multifetal pregnancy reduction (MFPR) or vanishing twin syndrome (VTS) at the Reproductive Medicine Hospital of the First Hospital of Lanzhou University. The comparator group included initial singleton pregnancies following IVF/ICSI-assisted conception. The study examined secondary outcomes including preterm birth, low birth weight, miscarriage rate, gestational age, and birth weight. No specific adverse events or discontinuations were reported in the safety section.
Regarding preterm birth and low birth weight rates, the MFPR group demonstrated significantly higher frequencies compared to both the VTS group and the control group, with a p-value less than 0.05 for both comparisons. Conversely, the VTS group exhibited comparable gestational age and birth weight metrics to the control group. Notably, the VTS group showed an even lower miscarriage rate than the control group, although no statistically significant difference was observed between the MFPR group and the control group for miscarriage rates.
Subgroup analysis within the MFPR cohort revealed that monochorionic diamniotic twin pregnancies carried a higher risk of miscarriage than dichorionic diamniotic twin pregnancies (p < 0.05). The study design is retrospective, which limits the ability to infer causality. Additionally, generalizability beyond the specific study setting may be restricted. These results highlight an association between surgical reduction and adverse perinatal outcomes in this specific population.
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