OP17.04: Multifetal reduction of triplets to twins compared to non‐reduced twins: a meta‐analysis
Bibliographic record
Abstract
Multifetal pregnancy reduction (MPR) of triplets' pregnancies to twins results in improved pregnancy outcomes when compared to non-reduced triplets. However, it is not clear whether the outcome of twin pregnancies following embryo reduction is similar to that of non-reduced twin pregnancies. The aim of this meta-analysis is to analyse the current literature regarding perinatal outcomes in twin pregnancies resulting from MPR compared with non-reduced twins. We conducted a systematic review of the available published data in accordance with the MOOSE recommendations. Databases that were included in our search strategy were MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and Web of Science. Data analysis was performed using the Cochrane's Review Manager 5.3 software. Our search yielded 615 publications of which 91 were assessed for eligibility. A total of 22 studies met our inclusion criteria. Fetal reduction of triplets to twins (n = 584) was associated with a comparable gestational age at delivery to non-reduced twins (n = 2,036) (mean difference −0.16 weeks [95% CI −0.44, 0.12], I = 25%). Similarly, the rate of pregnancy loss before 24 weeks' gestation was not different between the two groups (pooled Odds ratio 1.27 [95% CI 0.83-1.96]). Fetal reduction of triplets to twins (n = 729) was associated with a slight, albeit significant, lower birth weight at delivery compared with non-reduced twins (n = 2,792) (mean difference −53.60 g [95% CI −98.09, −9.10], I = 34%). Multifetal pregnancy reduction of triplets to twins was associated with a comparable gestational age at delivery and pregnancy loss before 24 weeks; however, it was also associated with a lower birth weight at delivery. This information can be used in creating guidelines on the number of embryos to transfer following in vitro fertilisation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.016 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.015 | 0.045 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".