547: Multifetal pregnancy reduction to singleton reduces the risk of small for gestational age neonates in comparison to twins

Abstract

FOR GESTATIONAL AGE NEONATES IN COMPARISON TO TWINS LAUREN FERRARA, MANISHA GANDHI, CHRISTIAN LITTON, VICTORIA BELOGOLOVKIN, JACQUELINE KAMRATH, E. CLAIR MCCLURG, ERIN MOSHIER, KEITH EDDLEMAN, JOANNE STONE, Mount Sinai School of Medicine, New York, New York, Mount Sinai School of Medicine, , New York, Mount Sinai School of Medicine, Department of Community and Preventive Medicine, New York, New York OBJECTIVE: Multiple gestations have been shown to have an increased risk of intrauterine growth restriction (IUGR). There has also been data to suggest that multifetal pregnancy reduction(MPR) is associated with IUGR. We sought out to determine if MPR reduces the risk of small for gestational age (SGA), defined as actual birthweight less that 10th percentile, in comparison to twin gestations who have undergone MPR as well as those who have had not had a reduction. STUDY DESIGN: We retrospectively identified all patients who had undergone MPR to either a singleton or twin gestation from an established MPR database and compared them to twin gestations extracted from our ultrasound database. Demographics including age, race, ART and cvs were collected. Birthweights were collected and categorized as less than 10th percentile based on gestational age and gender as described by Alexander et al. RESULTS: Complete data was available on 260 MPR singletons, 413 MPR twins, and 257 non-reduced twins. Reducing to a singleton gestation was associated with a statistically significant decrease small for gestational age neonates. CONCLUSION: Small for gestational age infants have a variety of clinical problems beginning at birth even if born at term. Reduction to a singleton gestation significantly decreases the likelihood of a small for gestational age infant when comparing not only to MPR twins but also to those who have not undergone this type of procedure. This should be an essential part of counseling patients who are considering this procedure.