Women who conceive twins or triplets after fertility treatment may be at increased risk of producing children with cerebral palsy.

Fertility treatment often leads to multiple births, as doctors hedge their bets about having a successful pregnancy outcome by implanting more than one fertilized egg. However, an Australian study has discovered that multiple birth babies are more likely to suffer from cerebral palsy than single birth babies.

Researchers in Western Australia examining all the multiple births in the region between 1980 and 1989 concluded: “Triplet pregnancies produced a child with cerebral palsy 47 times more often than singleton pregnancies did and twin pregnancies eight times more often.” Some 86 per cent of cerebral palsy in multiple births was in twins.

They found that even where twins were of normal birth weight, they were still at increased risk over singletons. “Although twins and triplets were more likely than singleton babies to be low in birth weight, their risks of cerebral palsy if low in birth weight were similar. In contrast, in normal birthweight categories twins had a higher rate of cerebral palsy than singletons,” say the researchers.

The prevalence of cerebral palsy was similar in non identical twins of unlike sex pairs, and in like sex pairs. “A twin pair in which one member died in utero was at higher risk of cerebral palsy: 96 per 1000 twin pairs compared with 12 for twin pregnancies in which both survived,” they said.

They conclude that couples contemplating IVF “need counselling that includes information on the full range of risks, including that of cerebral palsy, associated with multiple births.”

!ABMJ, 13 November 1993.

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Written by What Doctors Don't Tell You

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