TY - JOUR
T1 - Less is more
T2 - The risks of multiple births
AU - Elster, J. D.Nanette
AU - Andrews, J. D.Lori
AU - Dvorken, J. D.Rachel
AU - Gatter, J. D.Robert
AU - Horwich, J. D.Terri Finesmith
AU - Jaeger, J. D.Ami
AU - Klock, Susan
AU - Pergament, M. D.Eugene
AU - Pizzulli, J. D.Francis
AU - Shapiro, J. D.Robyn
AU - Siegler, M. D.Mark
AU - Smith, J. D.Peggie
PY - 2000/10
Y1 - 2000/10
N2 - Objective: To review the medical, social, and financial risks caused by the birth of multiples that need to be addressed in policy and practice. Result(s): Many risks of multiple births are described in the literature. The medical risks to the offspring include death, low birth weight, deformational plagiocephaly, and other physical and mental disabilities. Risks to the women include premature labor, premature delivery, pregnancy-induced hypertension, toxemia, gestational diabetes, and vaginal-uterine hemorrhage. Children born in multiples face difficulty socializing, developmental delays, and behavioral problems, whereas their parents risk exhaustion, depression, and anxiety. In addition to personal costs faced by families, society often bears the financial costs of overburdened hospitals, caps on insurance and/or inability of parents to cover expenses. Conclusion(s): Multiple births present potential acute and long-term medical risks to the pregnant woman and her children. However, more long-term follow-up research and more research on outcomes with higher-order multiples are needed. In designing practices and policies to improve the success of IVF while reducing the risk of multiples, it is important to balance the many interests involved. At a minimum, providers and patients need to be educated about the risks of multiple gestation so that steps can be taken to prevent adverse outcomes. (C) 2000 by American Society for Reproductive Medicine.
AB - Objective: To review the medical, social, and financial risks caused by the birth of multiples that need to be addressed in policy and practice. Result(s): Many risks of multiple births are described in the literature. The medical risks to the offspring include death, low birth weight, deformational plagiocephaly, and other physical and mental disabilities. Risks to the women include premature labor, premature delivery, pregnancy-induced hypertension, toxemia, gestational diabetes, and vaginal-uterine hemorrhage. Children born in multiples face difficulty socializing, developmental delays, and behavioral problems, whereas their parents risk exhaustion, depression, and anxiety. In addition to personal costs faced by families, society often bears the financial costs of overburdened hospitals, caps on insurance and/or inability of parents to cover expenses. Conclusion(s): Multiple births present potential acute and long-term medical risks to the pregnant woman and her children. However, more long-term follow-up research and more research on outcomes with higher-order multiples are needed. In designing practices and policies to improve the success of IVF while reducing the risk of multiples, it is important to balance the many interests involved. At a minimum, providers and patients need to be educated about the risks of multiple gestation so that steps can be taken to prevent adverse outcomes. (C) 2000 by American Society for Reproductive Medicine.
KW - Assisted reproductive technology
KW - Fertility
KW - In vitro fertilization
KW - Multiple birth risks
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U2 - 10.1016/S0015-0282(00)00713-5
DO - 10.1016/S0015-0282(00)00713-5
M3 - Review article
C2 - 11020494
AN - SCOPUS:17444446074
VL - 74
SP - 617
EP - 623
JO - Fertility and Sterility
JF - Fertility and Sterility
SN - 0015-0282
IS - 4
ER -
