Neonatal outcomes in singleton pregnancies conceived by fresh or frozen embryo transfer compared to spontaneous conceptions: a systematic review and meta-analysis
Purpose The use of assisted reproductive technology (ART) has increased in the last 2 decades and continuous surveillance is needed. This systematic review aims to assess the risk of adverse neonatal outcomes (preterm birth [PTB], low birth weight [LBW], small-for-gestationalage [SGA] and large for...
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| Veröffentlicht in: | Archives of gynecology and obstetrics 2020-07, Vol.302 (1), p.31-45 |
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| creator | Elias, Flavia T. S. Weber-Adrian, Danielle Pudwell, Jessica Carter, Jillian Walker, Mark Gaudet, Laura Smith, Graeme Velez, Maria P. |
| description | Purpose
The use of assisted reproductive technology (ART) has increased in the last 2 decades and continuous surveillance is needed. This systematic review aims to assess the risk of adverse neonatal outcomes (preterm birth [PTB], low birth weight [LBW], small-for-gestationalage [SGA] and large for gestational-age [LGA]), in singleton pregnancies conceived by fresh or frozen embryo transfer (FET) compared to spontaneous conceptions.
Methods
Cohort studies were identified from MEDLINE, Embase, Cochrane Library (January 2019), and manual search. Meta-analyses were performed to estimate odds ratios (OR) using random effects models in RevMan 5.3 and
I
-squared (
I
2
) test > 50% was considered as high heterogeneity.
Results
After 3142 titles and abstracts were screened, 1180 full-text articles were assessed, and 14 were eligible. For fresh embryo transfer, the pooled ORs were PTB 1.64 (95% CI 1.46, 1.84);
I
2
= 97%; LBW 1.67 (95% CI 1.52, 1.85);
I
2
= 94%; SGA 1.46 [95% CI 1.11, 1.92];
I
2
= 99%, LGA 0.88 (95% CI 0.80, 0.87);
I
2
= 80%). For frozen, the pooled ORs were PTB 1.39 (95% CI 1.34, 1.44);
I
2
= 0%; LBW 1.38 (95% CI 0.91, 2.09);
I
2
= 98%; SGA 0.83 (95% CI 0.57, 1.19);
I
2
= 0%, LGA 1.57 (95% CI 1.48, 1.68);
I
2
= 22%).
Conclusions
When compared with spontaneous pregnancies, fresh, but not frozen was associated with LBW and SGA. Both fresh and frozen were associated with PTB. Frozen was uniquely associated with LGA. Despite improvements in ART protocols in relation to pregnancy rates, attention is needed towards monitoring adverse neonatal outcomes in these pregnancies. |
| doi_str_mv | 10.1007/s00404-020-05593-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_2406305205</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2406305205</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-2bcd1216b92f031fe6c24a00516212122e3bfbf48cf6cbfe74f39141ea549e513</originalsourceid><addsrcrecordid>eNqNkk2P1DAMhisEYoeFP8ABReKChApOmqYdDiuhEV_SCi5wjtKMM5tVm5QknVX5OfxSMtth-DggTrHsx5bf-C2KxxReUIDmZQTgwEtgUEJdr6uS3ylWlFeshIbSu8UK1ocYRHNWPIjxGoCythX3i7OKcV7n_Kr4_hG9U0n1xE9J-wEjsY5E63Y9Ju_IGHDnlNM2F7R3Gu0et6SbiQkYr4gPOfDf0BEcujB7koJy0WDI8DCqkNnkSRy9S8qhn45DxmS9i6-IInGOCQeVrCYB9xZviHJbMmBSpXKqn6OND4t7RvURHx3f8-LL2zefN-_Ly0_vPmxeX5aaNzyVrNNbyqjo1sxARQ0KzbgCqKlgOc8YVp3pDG-1Eboz2HBTrSmnqGq-xppW58XFMnecugG3Gl0W08sx2EGFWXpl5Z8VZ6_kzu9lw4RoxWHAs-OA4L9OGJMcbNTY94t0yTiICmoGdUaf_oVe-ylkwbdU21SspW2m2ELp4GMMaE7LUJAHC8jFAjJbQN5aQPLc9OR3GaeWnzfPQLsAN9h5E_Np80VOGOQfq3hbC5EjYBub1OFYGz-5lFuf_39rpquFjplwOwy_RP5j_x8a1eHy</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2408732818</pqid></control><display><type>article</type><title>Neonatal outcomes in singleton pregnancies conceived by fresh or frozen embryo transfer compared to spontaneous conceptions: a systematic review and meta-analysis</title><source>SpringerNature Journals</source><source>Web of Science - Science Citation Index Expanded - 2020<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /></source><creator>Elias, Flavia T. S. ; Weber-Adrian, Danielle ; Pudwell, Jessica ; Carter, Jillian ; Walker, Mark ; Gaudet, Laura ; Smith, Graeme ; Velez, Maria P.</creator><creatorcontrib>Elias, Flavia T. S. ; Weber-Adrian, Danielle ; Pudwell, Jessica ; Carter, Jillian ; Walker, Mark ; Gaudet, Laura ; Smith, Graeme ; Velez, Maria P.</creatorcontrib><description>Purpose
The use of assisted reproductive technology (ART) has increased in the last 2 decades and continuous surveillance is needed. This systematic review aims to assess the risk of adverse neonatal outcomes (preterm birth [PTB], low birth weight [LBW], small-for-gestationalage [SGA] and large for gestational-age [LGA]), in singleton pregnancies conceived by fresh or frozen embryo transfer (FET) compared to spontaneous conceptions.
Methods
Cohort studies were identified from MEDLINE, Embase, Cochrane Library (January 2019), and manual search. Meta-analyses were performed to estimate odds ratios (OR) using random effects models in RevMan 5.3 and
I
-squared (
I
2
) test > 50% was considered as high heterogeneity.
Results
After 3142 titles and abstracts were screened, 1180 full-text articles were assessed, and 14 were eligible. For fresh embryo transfer, the pooled ORs were PTB 1.64 (95% CI 1.46, 1.84);
I
2
= 97%; LBW 1.67 (95% CI 1.52, 1.85);
I
2
= 94%; SGA 1.46 [95% CI 1.11, 1.92];
I
2
= 99%, LGA 0.88 (95% CI 0.80, 0.87);
I
2
= 80%). For frozen, the pooled ORs were PTB 1.39 (95% CI 1.34, 1.44);
I
2
= 0%; LBW 1.38 (95% CI 0.91, 2.09);
I
2
= 98%; SGA 0.83 (95% CI 0.57, 1.19);
I
2
= 0%, LGA 1.57 (95% CI 1.48, 1.68);
I
2
= 22%).
Conclusions
When compared with spontaneous pregnancies, fresh, but not frozen was associated with LBW and SGA. Both fresh and frozen were associated with PTB. Frozen was uniquely associated with LGA. Despite improvements in ART protocols in relation to pregnancy rates, attention is needed towards monitoring adverse neonatal outcomes in these pregnancies.</description><identifier>ISSN: 0932-0067</identifier><identifier>EISSN: 1432-0711</identifier><identifier>DOI: 10.1007/s00404-020-05593-4</identifier><identifier>PMID: 32445067</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Birth weight ; Embryos ; Endocrinology ; Gestational age ; Gynecology ; Human Genetics ; In vitro fertilization ; Infertility ; Life Sciences & Biomedicine ; Medicine ; Medicine & Public Health ; Meta-analysis ; Obstetrics ; Obstetrics & Gynecology ; Obstetrics/Perinatology/Midwifery ; Pregnancy ; Premature birth ; Public health ; Reproductive technologies ; Review ; Science & Technology ; Sperm ; Surrogate mothers ; Systematic review ; Uterus</subject><ispartof>Archives of gynecology and obstetrics, 2020-07, Vol.302 (1), p.31-45</ispartof><rights>The Author(s) 2020</rights><rights>The Author(s) 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>41</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000534856600002</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c474t-2bcd1216b92f031fe6c24a00516212122e3bfbf48cf6cbfe74f39141ea549e513</citedby><cites>FETCH-LOGICAL-c474t-2bcd1216b92f031fe6c24a00516212122e3bfbf48cf6cbfe74f39141ea549e513</cites><orcidid>0000-0003-4834-8279 ; 0000-0002-7142-6266 ; 0000-0002-3128-4523</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00404-020-05593-4$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00404-020-05593-4$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,315,781,785,886,27929,27930,28253,41493,42562,51324</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32445067$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Elias, Flavia T. S.</creatorcontrib><creatorcontrib>Weber-Adrian, Danielle</creatorcontrib><creatorcontrib>Pudwell, Jessica</creatorcontrib><creatorcontrib>Carter, Jillian</creatorcontrib><creatorcontrib>Walker, Mark</creatorcontrib><creatorcontrib>Gaudet, Laura</creatorcontrib><creatorcontrib>Smith, Graeme</creatorcontrib><creatorcontrib>Velez, Maria P.</creatorcontrib><title>Neonatal outcomes in singleton pregnancies conceived by fresh or frozen embryo transfer compared to spontaneous conceptions: a systematic review and meta-analysis</title><title>Archives of gynecology and obstetrics</title><addtitle>Arch Gynecol Obstet</addtitle><addtitle>ARCH GYNECOL OBSTET</addtitle><addtitle>Arch Gynecol Obstet</addtitle><description>Purpose
The use of assisted reproductive technology (ART) has increased in the last 2 decades and continuous surveillance is needed. This systematic review aims to assess the risk of adverse neonatal outcomes (preterm birth [PTB], low birth weight [LBW], small-for-gestationalage [SGA] and large for gestational-age [LGA]), in singleton pregnancies conceived by fresh or frozen embryo transfer (FET) compared to spontaneous conceptions.
Methods
Cohort studies were identified from MEDLINE, Embase, Cochrane Library (January 2019), and manual search. Meta-analyses were performed to estimate odds ratios (OR) using random effects models in RevMan 5.3 and
I
-squared (
I
2
) test > 50% was considered as high heterogeneity.
Results
After 3142 titles and abstracts were screened, 1180 full-text articles were assessed, and 14 were eligible. For fresh embryo transfer, the pooled ORs were PTB 1.64 (95% CI 1.46, 1.84);
I
2
= 97%; LBW 1.67 (95% CI 1.52, 1.85);
I
2
= 94%; SGA 1.46 [95% CI 1.11, 1.92];
I
2
= 99%, LGA 0.88 (95% CI 0.80, 0.87);
I
2
= 80%). For frozen, the pooled ORs were PTB 1.39 (95% CI 1.34, 1.44);
I
2
= 0%; LBW 1.38 (95% CI 0.91, 2.09);
I
2
= 98%; SGA 0.83 (95% CI 0.57, 1.19);
I
2
= 0%, LGA 1.57 (95% CI 1.48, 1.68);
I
2
= 22%).
Conclusions
When compared with spontaneous pregnancies, fresh, but not frozen was associated with LBW and SGA. Both fresh and frozen were associated with PTB. Frozen was uniquely associated with LGA. Despite improvements in ART protocols in relation to pregnancy rates, attention is needed towards monitoring adverse neonatal outcomes in these pregnancies.</description><subject>Birth weight</subject><subject>Embryos</subject><subject>Endocrinology</subject><subject>Gestational age</subject><subject>Gynecology</subject><subject>Human Genetics</subject><subject>In vitro fertilization</subject><subject>Infertility</subject><subject>Life Sciences & Biomedicine</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meta-analysis</subject><subject>Obstetrics</subject><subject>Obstetrics & Gynecology</subject><subject>Obstetrics/Perinatology/Midwifery</subject><subject>Pregnancy</subject><subject>Premature birth</subject><subject>Public health</subject><subject>Reproductive technologies</subject><subject>Review</subject><subject>Science & Technology</subject><subject>Sperm</subject><subject>Surrogate mothers</subject><subject>Systematic review</subject><subject>Uterus</subject><issn>0932-0067</issn><issn>1432-0711</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>AOWDO</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkk2P1DAMhisEYoeFP8ABReKChApOmqYdDiuhEV_SCi5wjtKMM5tVm5QknVX5OfxSMtth-DggTrHsx5bf-C2KxxReUIDmZQTgwEtgUEJdr6uS3ylWlFeshIbSu8UK1ocYRHNWPIjxGoCythX3i7OKcV7n_Kr4_hG9U0n1xE9J-wEjsY5E63Y9Ju_IGHDnlNM2F7R3Gu0et6SbiQkYr4gPOfDf0BEcujB7koJy0WDI8DCqkNnkSRy9S8qhn45DxmS9i6-IInGOCQeVrCYB9xZviHJbMmBSpXKqn6OND4t7RvURHx3f8-LL2zefN-_Ly0_vPmxeX5aaNzyVrNNbyqjo1sxARQ0KzbgCqKlgOc8YVp3pDG-1Eboz2HBTrSmnqGq-xppW58XFMnecugG3Gl0W08sx2EGFWXpl5Z8VZ6_kzu9lw4RoxWHAs-OA4L9OGJMcbNTY94t0yTiICmoGdUaf_oVe-ylkwbdU21SspW2m2ELp4GMMaE7LUJAHC8jFAjJbQN5aQPLc9OR3GaeWnzfPQLsAN9h5E_Np80VOGOQfq3hbC5EjYBub1OFYGz-5lFuf_39rpquFjplwOwy_RP5j_x8a1eHy</recordid><startdate>20200701</startdate><enddate>20200701</enddate><creator>Elias, Flavia T. S.</creator><creator>Weber-Adrian, Danielle</creator><creator>Pudwell, Jessica</creator><creator>Carter, Jillian</creator><creator>Walker, Mark</creator><creator>Gaudet, Laura</creator><creator>Smith, Graeme</creator><creator>Velez, Maria P.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>AOWDO</scope><scope>BLEPL</scope><scope>DTL</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-4834-8279</orcidid><orcidid>https://orcid.org/0000-0002-7142-6266</orcidid><orcidid>https://orcid.org/0000-0002-3128-4523</orcidid></search><sort><creationdate>20200701</creationdate><title>Neonatal outcomes in singleton pregnancies conceived by fresh or frozen embryo transfer compared to spontaneous conceptions: a systematic review and meta-analysis</title><author>Elias, Flavia T. S. ; Weber-Adrian, Danielle ; Pudwell, Jessica ; Carter, Jillian ; Walker, Mark ; Gaudet, Laura ; Smith, Graeme ; Velez, Maria P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-2bcd1216b92f031fe6c24a00516212122e3bfbf48cf6cbfe74f39141ea549e513</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Birth weight</topic><topic>Embryos</topic><topic>Endocrinology</topic><topic>Gestational age</topic><topic>Gynecology</topic><topic>Human Genetics</topic><topic>In vitro fertilization</topic><topic>Infertility</topic><topic>Life Sciences & Biomedicine</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Meta-analysis</topic><topic>Obstetrics</topic><topic>Obstetrics & Gynecology</topic><topic>Obstetrics/Perinatology/Midwifery</topic><topic>Pregnancy</topic><topic>Premature birth</topic><topic>Public health</topic><topic>Reproductive technologies</topic><topic>Review</topic><topic>Science & Technology</topic><topic>Sperm</topic><topic>Surrogate mothers</topic><topic>Systematic review</topic><topic>Uterus</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Elias, Flavia T. S.</creatorcontrib><creatorcontrib>Weber-Adrian, Danielle</creatorcontrib><creatorcontrib>Pudwell, Jessica</creatorcontrib><creatorcontrib>Carter, Jillian</creatorcontrib><creatorcontrib>Walker, Mark</creatorcontrib><creatorcontrib>Gaudet, Laura</creatorcontrib><creatorcontrib>Smith, Graeme</creatorcontrib><creatorcontrib>Velez, Maria P.</creatorcontrib><collection>Springer Nature OA/Free Journals</collection><collection>Web of Science - Science Citation Index Expanded - 2020</collection><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Archives of gynecology and obstetrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Elias, Flavia T. S.</au><au>Weber-Adrian, Danielle</au><au>Pudwell, Jessica</au><au>Carter, Jillian</au><au>Walker, Mark</au><au>Gaudet, Laura</au><au>Smith, Graeme</au><au>Velez, Maria P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Neonatal outcomes in singleton pregnancies conceived by fresh or frozen embryo transfer compared to spontaneous conceptions: a systematic review and meta-analysis</atitle><jtitle>Archives of gynecology and obstetrics</jtitle><stitle>Arch Gynecol Obstet</stitle><stitle>ARCH GYNECOL OBSTET</stitle><addtitle>Arch Gynecol Obstet</addtitle><date>2020-07-01</date><risdate>2020</risdate><volume>302</volume><issue>1</issue><spage>31</spage><epage>45</epage><pages>31-45</pages><issn>0932-0067</issn><eissn>1432-0711</eissn><abstract>Purpose
The use of assisted reproductive technology (ART) has increased in the last 2 decades and continuous surveillance is needed. This systematic review aims to assess the risk of adverse neonatal outcomes (preterm birth [PTB], low birth weight [LBW], small-for-gestationalage [SGA] and large for gestational-age [LGA]), in singleton pregnancies conceived by fresh or frozen embryo transfer (FET) compared to spontaneous conceptions.
Methods
Cohort studies were identified from MEDLINE, Embase, Cochrane Library (January 2019), and manual search. Meta-analyses were performed to estimate odds ratios (OR) using random effects models in RevMan 5.3 and
I
-squared (
I
2
) test > 50% was considered as high heterogeneity.
Results
After 3142 titles and abstracts were screened, 1180 full-text articles were assessed, and 14 were eligible. For fresh embryo transfer, the pooled ORs were PTB 1.64 (95% CI 1.46, 1.84);
I
2
= 97%; LBW 1.67 (95% CI 1.52, 1.85);
I
2
= 94%; SGA 1.46 [95% CI 1.11, 1.92];
I
2
= 99%, LGA 0.88 (95% CI 0.80, 0.87);
I
2
= 80%). For frozen, the pooled ORs were PTB 1.39 (95% CI 1.34, 1.44);
I
2
= 0%; LBW 1.38 (95% CI 0.91, 2.09);
I
2
= 98%; SGA 0.83 (95% CI 0.57, 1.19);
I
2
= 0%, LGA 1.57 (95% CI 1.48, 1.68);
I
2
= 22%).
Conclusions
When compared with spontaneous pregnancies, fresh, but not frozen was associated with LBW and SGA. Both fresh and frozen were associated with PTB. Frozen was uniquely associated with LGA. Despite improvements in ART protocols in relation to pregnancy rates, attention is needed towards monitoring adverse neonatal outcomes in these pregnancies.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>32445067</pmid><doi>10.1007/s00404-020-05593-4</doi><tpages>15</tpages><orcidid>https://orcid.org/0000-0003-4834-8279</orcidid><orcidid>https://orcid.org/0000-0002-7142-6266</orcidid><orcidid>https://orcid.org/0000-0002-3128-4523</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Archives of gynecology and obstetrics, 2020-07, Vol.302 (1), p.31-45 |
| issn | 0932-0067 1432-0711 |
| language | eng |
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| source | SpringerNature Journals; Web of Science - Science Citation Index Expanded - 2020<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /> |
| subjects | Birth weight Embryos Endocrinology Gestational age Gynecology Human Genetics In vitro fertilization Infertility Life Sciences & Biomedicine Medicine Medicine & Public Health Meta-analysis Obstetrics Obstetrics & Gynecology Obstetrics/Perinatology/Midwifery Pregnancy Premature birth Public health Reproductive technologies Review Science & Technology Sperm Surrogate mothers Systematic review Uterus |
| title | Neonatal outcomes in singleton pregnancies conceived by fresh or frozen embryo transfer compared to spontaneous conceptions: a systematic review and meta-analysis |
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