Skip to content
DraconiticResearch
Search Sources API
203,203 studies31 sourcesUpdated 6 min ago
Peer-reviewedCC BY 4.0Frontiers in Endocrinology

Impact of surgical versus spontaneous fetal reduction on maternal and neonatal outcomes after assisted reproductive technology: a single-center cohort study of 1, 451 singleton live births

  • Junzhai Song1
  • Ting Zhang1
  • Kaili Wang1
  • Zhaozhao Liu1
  • Canyu Li1
  1. 1Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University
Read full textPDFDOICite

Abstract

Objective: To compare maternal and neonatal outcomes among pregnancies with surgical reduction, spontaneous reduction, and initial singleton pregnancies following assisted reproductive technology (ART), and to identify independent risk factors for adverse obstetric outcomes.

Methods: This retrospective cohort study included 1,451 singleton live births after ART at a single center from January 2018 to December 2023. Participants were divided into three groups: surgical reduction (n=128), spontaneous reduction (n=156), and initial singleton control group (n=1,167). Baseline characteristics, maternal complications, and neonatal outcomes were compared. Multivariate logistic regression was performed to identify independent risk factors.

Results: Univariate analysis revealed significant intergroup differences in the incidence of gestational diabetes mellitus (GDM) and preterm birth. The GDM rate was highest in the spontaneous reduction group (26.92%), followed by the surgical reduction group (19.53%) and singleton controls (15.94%, P = 0.003). Preterm birth also differed significantly across groups (19.23% vs 14.06% vs 11.83%, P = 0.024). No group differences were detected for hypertensive disorders of pregnancy, placental complications, or congenital birth defects. After adjusting for maternal age, pre-pregnancy BMI, embryo type, No. of embryos transferred and embryo stage, multivariate logistic regression showed that surgical reduction ( OR = 1.22, 95%CI 0.98-1.52, P = 0.069) and spontaneous reduction ( OR = 1.39, 95%CI 0.98-1.98, P = 0.067) were not independent risk factors for GDM. Advanced maternal age ( OR = 1.12, 95%CI 1.01-1.23, P = 0.028) and elevated pre-pregnancy BMI ( OR = 1.11, 95%CI 1.01-1.21, P = 0.030) were the only independent predictors of GDM. For preterm birth, both surgical reduction ( OR = 1.35, 95%CI 1.09-1.68, P = 0.007) and spontaneous reduction ( OR = 1.72, 95%CI 1.20-2.45, P = 0.003) were independently associated with higher odds of preterm birth. Although the adjusted OR was numerically higher for spontaneous reduction than for surgical reduction, a direct comparison between the two methods showed no statistically significant difference.

Conclusion: In ART singleton live births, a history of fetal reduction (surgical or spontaneous) was not independently associated with GDM, but both reduction modalities were independently associated with higher odds of preterm birth.

Related

  1. Editorial: Advancing embryo transfer in assisted reproductive technology
    Claudio M. M. Brigante, Mario Romano Mignini Renzini, José Buratini
    Frontiers in EndocrinologyPeer-reviewedCC BY 4.0Endocrinology & metabolismCrossref
  2. New challenges in in vitro fertilization and assisted reproductive technology: Genetic and epigenetic modifications
    Jacek Z. Kubiak
    Journal of Clinical and Translational ResearchPeer-reviewedCC BY-NC 4.0Full textObstetrics, gynaecology & paediatricsHAL
  3. Prediction of chemical miscarriage in assisted reproductive technology pregnancies using machine learning: A developmental study
    Mohadese Zare Ebrahimabad, Mahdi Hashemzadeh, Nasim Tabibnejad
    International journal of reproductive biomedicinePeer-reviewedCC BY-NCFull textGeneral medicineEurope PMC
  4. Recombinant follicle‐stimulating hormone (rFSH) versus other recombinant or urinary gonadotropins for ovarian stimulation in assisted reproductive technology cycles
    Robbert P Berkhout, Elena B Kostova, Madelon Wely
    The Cochrane Database of Systematic ReviewsPeer-reviewedPublisher termsFull text1 citedObstetrics, gynaecology & paediatricsPMC
  5. Culture media for human pre‐implantation embryos in assisted reproductive technology cycles
    Maitane Laverde, Miriam Zagers, Madelon Wely +3
    The Cochrane Database of Systematic ReviewsPeer-reviewedPublisher termsFull textEpidemiology & public healthPMC

Cite

BibTeXRIS
BibTeX
@article{song2026impact,
  title = {{Impact of surgical versus spontaneous fetal reduction on maternal and neonatal outcomes after assisted reproductive technology: a single-center cohort study of 1, 451 singleton live births}},
  author = {Junzhai Song and Ting Zhang and Kaili Wang and Zhaozhao Liu and Canyu Li},
  journal = {Frontiers in Endocrinology},
  year = {2026},
  month = oct,
  doi = {10.3389/fendo.2026.1923529},
  url = {https://www.frontiersin.org/articles/10.3389/fendo.2026.1923529/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Impact of surgical versus spontaneous fetal reduction on maternal and neonatal outcomes after assisted reproductive technology: a single-center cohort study of 1, 451 singleton live births
AU  - Junzhai Song
AU  - Ting Zhang
AU  - Kaili Wang
AU  - Zhaozhao Liu
AU  - Canyu Li
PY  - 2026
DA  - 2026/10/26
JO  - Frontiers in Endocrinology
DO  - 10.3389/fendo.2026.1923529
UR  - https://www.frontiersin.org/articles/10.3389/fendo.2026.1923529/full
AB  - Objective: To compare maternal and neonatal outcomes among pregnancies with surgical reduction, spontaneous reduction, and initial singleton pregnancies following assisted reproductive technology (ART), and to identify independent risk factors for adverse obstetric outcomes.  Methods: This retrospective cohort study included 1,451 singleton live births after ART at a single center from January 2018 to December 2023. Participants were divided into three groups: surgical reduction (n=128), spontaneous reduction (n=156), and initial singleton control group (n=1,167). Baseline characteristics, maternal complications, and neonatal outcomes were compared. Multivariate logistic regression was performed to identify independent risk factors.  Results: Univariate analysis revealed significant intergroup differences in the incidence of gestational diabetes mellitus (GDM) and preterm birth. The GDM rate was highest in the spontaneous reduction group (26.92%), followed by the surgical reduction group (19.53%) and singleton controls (15.94%, P = 0.003). Preterm birth also differed significantly across groups (19.23% vs 14.06% vs 11.83%, P = 0.024). No group differences were detected for hypertensive disorders of pregnancy, placental complications, or congenital birth defects. After adjusting for maternal age, pre-pregnancy BMI, embryo type, No. of embryos transferred and embryo stage, multivariate logistic regression showed that surgical reduction ( OR = 1.22, 95%CI 0.98-1.52, P = 0.069) and spontaneous reduction ( OR = 1.39, 95%CI 0.98-1.98, P = 0.067) were not independent risk factors for GDM. Advanced maternal age ( OR = 1.12, 95%CI 1.01-1.23, P = 0.028) and elevated pre-pregnancy BMI ( OR = 1.11, 95%CI 1.01-1.21, P = 0.030) were the only independent predictors of GDM. For preterm birth, both surgical reduction ( OR = 1.35, 95%CI 1.09-1.68, P = 0.007) and spontaneous reduction ( OR = 1.72, 95%CI 1.20-2.45, P = 0.003) were independently associated with higher odds of preterm birth. Although the adjusted OR was numerically higher for spontaneous reduction than for surgical reduction, a direct comparison between the two methods showed no statistically significant difference.  Conclusion: In ART singleton live births, a history of fetal reduction (surgical or spontaneous) was not independently associated with GDM, but both reduction modalities were independently associated with higher odds of preterm birth.
SN  - 1664-2392
ER  -