REPRODUCTIVE POTENTIAL OF THE LAKOR GOAT IN LAKOR ISLAND, SOUTHWEST MALUKU REGENCY

This study aims to determine the reproductive potential of the lakor goat in Lakor Disctrict, Southwest Maluku Regency. This research was conducted from July to August 2020 in three sample villages, namely Letoda, Sera, and Yamluli Villages. The methoud used in this study was a survey of 30 respondents of Lakor goat breeders who were determined by the simple random sampling method (simple random). The data source used in this study is primary data. The data was collected by means of observation and direct interview using a questionnaire. The results showed that the reproductive potential of the Lakor goat in the three sample villages categorized as good according to the amount of litter obtained from the type of twin birth which is quite high and the ability to give birth.

Secular Trend of Twin Birth Rate in Metropolitan Cities of Korea, 2000-2019

Objectives: To analyze the seven metropolitan cities of twin birth rate per 100 births (TBR) from 2000 to 2019 in Korea.Methods: We used the 2000-2019 birth certificated data (3,949,097 births) of seven metropolitan cities from Statistics Korea. The data of extra-marital birth and information missing cases (maternal and paternal age and triplet birth) were excluded. The odds ratio and 95% confidence intervals were calculated using logistic regression to describe the regional variance of TBR adjusted for maternal age, age difference between couple and maternal educational backgrounds.Results: During this period (2000-2019 years), the highest TBR by region was observed in Ulsan and Seoul metropolitan city (3.0), and the lowest TBR in Deagu metropolitan city (2.6). The TBR increased by 275 percent from 1.74 in 2000 to 4.79 in 2019. During the period from 2000-2004 to 2015-2019, there was the highest increment of TBR in Ulsan metropolitan city (odds ratio: 1.78; 95% confidence interval: 1.64-1.92) and Busan metropolitan city (1.74; 1.65-1.83), and the lowest increment in Daegu metropolitan city (1.24; 1.17-1.31), after adjustment by logistic regression for demographic variables. During the period 2015-2019 years, there was a significant increase the odds ratio of TBR in Ulsan metropolitan city (1.39), Busan metropolitan city (1.33), Seoul metropolitan city (1.25) and Incheon metropolitan city (1.23), as compared with the TBR of Deagu metropolitan city.Conclusions: Over the past two decades, TBR have risen dramatically in metropolitan cities of Korea. Regional variance of TBR was observed among metropolitan cities in Korea. There is a need for more research to understand the socio-demographic and medical factors associated with regional differences. The national birth registration system needs to be reformed to monitor whether twin births are spontaneous or assisted pregnancy.

P–668 We aim for one baby, not one embryo: a personalized ET strategy based on embryo score and woman age maximizes LB and minimizes twins

Study question Is it possible to define a personalized ET model to maximize the chance of live birth (LB) while minimizing the risk of twin pregnancy? Summary answer A model including age and embryo morphological score can inform a personalized ET strategy to maximize LB while minimizing the risk of twin pregnancy. What is known already The morphological score of the transferred embryos affects pregnancy (PR) and LB rates in IVF cycles. Although SET is mainly recommended to avoid multiple pregnancies, DET is still being performed extensively, especially in patients with poor prognosis, with the aim to improve PR per transfer and shorten time to pregnancy. While twin pregnancies are associated with an increased risk of maternal and fetal complications, very low PR may increase patient drop-off, extend time to pregnancy, and increase the cost per successful transfer. A personalized transfer strategy balancing high LB per transfer with low twin pregnancy rates should be defined. Study design, size, duration Retrospective study including 2,470 fresh and frozen embryo transfers (ET) of either one or two embryos at D3 from January 2016 to August 2019 in a single IVF clinic. Biochemical, clinical, multiple pregnancy and live birth rates after SET and DET were analyzed according to the morphological score of the embryos transferred. ETs were divided into 9 groups according to the combinations of their embryo morphological scores. Participants/materials, setting, methods Embryos were assessed on D3 following a national recommended morphological scale. Morphology was categorized as High (H) if A or B+, medium (M) if B or C+, and Low (L) if C or D. The likelihood of biochemical, clinical pregnancy and live birth, and the risk of multiple pregnancy, after SET and DET of embryos of different scores was analyzed. A logistic regression analysis adjusted by age of the woman was ran for each outcome. Main results and the role of chance The distribution of ETs among the 9 groups for SET was: 510 H, 715 M, 346 L; for DET: 142 HH, 148 HM, 29 HL, 268 MM, 164 ML, 148 LL. Mean woman age was similar among groups: 38.7±4.01. Live birth and twin rates increased with embryo score. Considering a SET of category M as reference, the OR of live birth in DET were: 2.76 [1.82, 4.19 95%CI] for HH, and 2.32 [1.51, 3.55 95%CI] for HM, and 1.69 [1.19, 2.40 95%CI] for MM, and in SET: 1.52 [1.12, 2.04 95%CI] for H. Considering a DET of category MM as reference, the OR of twin birth in DET were: 2.8 [1.14, 6.99 95%CI] for HH, 2.5 [0.98, 6.46 95%CI] for HM, and 0.92 [0.11, 7.84 95%CI] for HL. According to this model, a 38y.o. woman with a SET of category M would have a 16% chance of live birth, and no twins. The addition of an M (DET: MM) increases her chance of live birth to 24% with a 2.9% risk of twins. The addition of a H (DET:MH) would increase further her chance of live birth to 30.8%, however, the increase would be due almost exclusively to twins (7%). Limitations, reasons for caution The limitations of this study are its retrospective nature and the small size of some categories. Embryos were classified using a national morphological scale; other morphological classifications could influence the results. The development and validation of site-specific models, using local patients’ data, is recommended before their use in clinical practice. Wider implications of the findings: A personalized assessment of embryo quality and woman age, at a minimum, are necessary to identify the best ET strategy for each patient; this strategy allows to maximize live birth rates while keeping the risk of twin birth as low as possibl. Trial registration number Not applicable

Should singleton birth weight standards be applied to identify small-for-gestational age twins?: analysis of a retrospective cohort study

Background Twin birth weight percentiles are less popular in clinical management among twin pregnancies compared with singleton ones in China. This study aimed to compare the incidence and neonatal outcomes of small for gestational age (SGA) twins between the use of singleton and twin birth weight percentiles. Methods This was a retrospective cohort study of 3,027 pregnancies with liveborn twin pairs at gestational age of > 28 weeks. The newborns were categorized as SGA when a birthweight was less than the 10th percentile based on the singleton and twin references derived from Chinese population. Logistic regression models with generalized estimated equation (GEE) were utilized to evaluate the association between SGA twins and neonatal outcomes including neonatal unit admission, neonatal jaundice, neonatal respiratory distress (NRDS), neonatal asphyxia, ventilator support, hypoxic ischemic encephalopathy (HIE), bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), intracranial hemorrhage (ICH), culture-proven sepsis, neonatal death within 28 days after birth as well as the composite outcome. Results The incidence of SGA was 33.1 % based on the singleton reference and 7.3 % based on the twin reference. Both of SGA newborns defined by the singleton and twin references were associated with increases in neonatal unit admission, neonatal jaundice and ventilator support. In addition, SGA newborns defined by the twin reference were associated with increased rates of BPD (aOR, 2.61; 95 % CI: 1.18–5.78) as well as the severe composite outcome (aOR, 1.93; 95 % CI: 1.07–3.47). Conclusions The use of singleton birth weight percentiles may result in misdiagnosed SGA newborns in twin gestations and the twin birth weight percentiles would be more useful to identify those who are at risk of adverse outcomes.

Assessments of Birth Outcome of Twin Delivery and Associated Factors among Newborns in Dessie Referral Hospital, Dessie, Ethiopia, 2019

Background. There was a fast improvement of twin’s birth outcomes in the past decade, but it was average in developing countries. Stillbirth, preterm birth, low birth weight, and birth asphyxia are the major contributors to poor twin birth outcomes. This study was crucial to address the gaps and clarify the outcome of twin delivery. Objectives. To assess the birth outcome of twin delivery and associated factors among newborns who were delivered in Dessie Referral Hospital, Ethiopia, 2019. Methods. Institutional-based retrospective cross-sectional study was employed among 385 maternal records from Nov 10/2013 to Dec 10/2019. Data were selected by using a random sampling technique. Frequencies, proportion, and summary statics were used to describe the study population. The data were entered into Epi Info and exported in the SPSS version 20 for analysis. All variables with p value < 0.20 in bivariable logistic regression analysis were considered for multivariable logistic regression analysis; adjusted odds ratio with 95% confidence interval was used to measure the association variable with p value < 0.05 which was statistically significant. Results. This finding showed that the prevalence of twin birth outcome accounts 23.4% (95 % CI, 19.2–27.5). Low birth weight 9.1%, stillbirth 4.2%, Apgar score < 7 9.1%, and neonatal death 1 % were accounted. Hypertension disorder (95% CI, 6.01(2.43–14.87)), rural residence (95% CI 2.46(1.39–4.37)), PROM (95% CI 6.39(2.52–16.16)), and no ANC follow-up (95% CI, 13.47(2.49–72.85)) were significantly associated with adverse twin birth. Conclusions and Recommendations. Magnitude of twins’ adverse birth outcome was 23.4%. Hypertension disorder, rural residence, PROM, and no ANC follow-up were significant variables for twins’ adverse birth outcome. Therefore, all healthcare providers should give sustainable educations and instructions about the importance of sticking with the recommended ANC follow-up.