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doi:10.1136/bmj.a1129

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Technology is not to blame for adverse perinatal outcomes in assisted conception

Lancet2008; doi: 10.1016/S0140-6736(08)61042-7

Singleton babies born after assisted fertilisation are at higher risk of low birth weight, preterm delivery, and perinatal death than spontaneously conceived ones⇑. But a new study suggests that this is mainly the result of factors associated with infertility rather than the technology itself.

A Norwegian population based cohort study, which compared perinatal outcomes in more than 1 200 000 singletons born as a result of spontaneous conception and more than 8000 singletons born after assisted conception, found that those born after assisted conception were lighter at birth (difference 25 g, 95% CI 14 to 35), had shorter duration of gestation (2.0 days, 1.6 to 2.3), and had an increased risk of perinatal death (odds ratio 1.31, 1.05 to 1.65) and being small for gestational age (1.26, 1.10 to 1.44).

However, when the researchers compared babies born to 2546 women who, in consecutive pregnancies, gave birth to a singleton after assisted conception and after spontaneous conception, they found that outcomes differed little (difference in birth weight 9 g, −18 to 36; gestational age 0.6 days, −0.5 to 1.7; and odds ratio for small for gestational age 0.99, 0.62 to 1.57). Babies born after assisted conception even had a lower risk of perinatal death (0.36, 0.20 to 0.67).

Ciclosporin reduces myocardial reperfusion injury

N Engl J Med2008;359:473-81

OpenUrl CrossRef Medline

A pilot study tested a hypothesis that because ciclosporin inhibits the opening of the mitochondrial permeability transition pores, it might attenuate myocardial reperfusion injury, which in patients with myocardial infarction accounts for up to a half of the final size of the infarct⇑. Fifty eight people with acute ST elevation myocardial infarction were randomised to an intravenous bolus of 2.5 mg of ciclosporin per kg of body weight, or saline, before undergoing percutaneous coronary intervention.

Ciclosporin significantly reduced the release of creatine kinase (P=0.04) and lowered troponin I, although not significantly …