Morbidity in a Danish national cohort of 472 IVF/ICSI twins, 1132 non-IVF/ICSI twins and 634 IVF/ICSI singletons: health-related and social implications for the children and their families

Hum Reprod. 2003 Jun;18(6):1234-43. doi: 10.1093/humrep/deg257.

Abstract

Background: There is a lack of knowledge on child health as well as family well-being in IVF/ICSI twins.

Methods: These data originated from questionnaires completed by mothers taking part in a national cohort study of twin and singleton births occurring in Denmark in 1997. The overall response rate was 83%. The three cohorts consisted of all IVF/ICSI twin children (n = 472), all IVF/ICSI singletons (n = 634) and all non-IVF/ICSI twin children (n = 1132) born in Denmark in 1997.

Results: No major differences in physical health were observed between IVF/ICSI twins and non-IVF/ICSI twins. Compared with IVF/ICSI singletons, more IVF/ICSI twins were admitted to a neonatal intensive care unit (NICU) (P < 0.01) and more had surgical interventions (P = 0.03) and special needs (P = 0.02), moreover they had poorer speech development (P < 0.01). Correspondingly, IVF/ICSI twin mothers rated their infant's general health poorer than IVF/ICSI singleton mothers did. All discrepancies between IVF/ICSI twins and singletons disappeared after stratification for birthweight except for NICU admissions and speech development. Multiple logistic regression analyses showed that both IVF/ICSI and non-IVF/ICSI twin parents experienced more marital stress [odds ratio (OR) 2.9, 95% CI 2.2-3.8] and that twins had more impact on the mother's life (OR 1.7, 95% CI 1.2-2.4) compared with singletons. Nevertheless, the only predictor of low divorce/separation risk was IVF/ICSI treatment.

Conclusion: Our study indicates that physical health of IVF/ICSI twins is comparable with that of non-IVF/ICSI twins. However, physical health of IVF/ICSI twins is poorer and the implications for the families stronger compared with IVF/ICSI singletons.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Birth Weight
  • Cohort Studies
  • Congenital Abnormalities / epidemiology
  • Congenital Abnormalities / surgery
  • Denmark
  • Developmental Disabilities
  • Disabled Children
  • Diseases in Twins*
  • Family*
  • Female
  • Fertilization in Vitro*
  • Health Status*
  • Humans
  • Infant
  • Infant Mortality
  • Infant, Newborn
  • Intensive Care, Neonatal
  • Maternal Age
  • Morbidity
  • Nervous System Diseases / epidemiology
  • Parity
  • Pregnancy
  • Pregnancy Outcome
  • Social Behavior
  • Social Class
  • Sperm Injections, Intracytoplasmic*
  • Surveys and Questionnaires
  • Twins*