Maternal and perinatal outcomes in spontaneous versus assisted conception twin pregnancies

D Caserta; G Bordi; M Stegagno; F Filippini; M Podagrosi; D Roselli; M Moscarini

doi:10.1016/j.ejogrb.2013.12.011

Maternal and perinatal outcomes in spontaneous versus assisted conception twin pregnancies

Eur J Obstet Gynecol Reprod Biol. 2014 Mar:174:64-9. doi: 10.1016/j.ejogrb.2013.12.011. Epub 2013 Dec 15.

Authors

D Caserta¹, G Bordi², M Stegagno³, F Filippini⁴, M Podagrosi⁴, D Roselli⁵, M Moscarini²

Affiliations

¹ Department of Gynaecologic-Obstetrical Sciences and Urological Sciences, University of Rome Sapienza, S. Andrea Hospital, Rome, Italy. Electronic address: donatella.caserta@uniroma1.it.
² Department of Gynaecologic-Obstetrical Sciences and Urological Sciences, University of Rome Sapienza, S. Andrea Hospital, Rome, Italy.
³ Department of Gynaecologic-Obstetrical Sciences and Urological Sciences, University of Rome Sapienza, S. Andrea Hospital, Rome, Italy; Neonatal Unit of S. Pietro Fatebenefratelli Hospital, Rome, Italy.
⁴ Neonatal Unit of S. Pietro Fatebenefratelli Hospital, Rome, Italy.
⁵ Department of Obstetrics and Gynaecology, S. Pietro Fatebenefratelli Hospital, Rome, Italy.

PMID: 24405729
DOI: 10.1016/j.ejogrb.2013.12.011

Abstract

Objective: To compare maternal and perinatal outcomes in twin pregnancies conceived via assisted reproductive techniques (ART) compared with spontaneous twin pregnancies.

Study design: This retrospective study examined 345 dichorionic, di-amniotic twin pregnancies (207 conceived spontaneously and 138 conceived via ART), delivered between January 2007 and June 2011 at the San Pietro Fatebenefratelli Hospital, Rome, a tertiary medical centre. Maternal and perinatal outcomes were compared. A multiple logistic regression analysis was performed to calculate risk estimates as odds ratios (OR) adjusted for maternal age, parity and systemic diseases. Patient data were obtained from a computerized database and analyzed using Statistical Package for the Social Sciences Version 17.

Results: Gestational age and birth weight were lower in the ART group, and preterm delivery, gestational diabetes and placental abruption were higher in the ART group compared with the spontaneous conception group. The incidence rates of respiratory complications, patent ductus arteriosus and admission to the neonatal intensive care unit were higher among ART newborns. Length of hospital stay for mothers and newborns was longer in the ART group. No differences in mode of delivery, Apgar score at 5min, congenital anomalies, perinatal mortality, and other considered pregnancy and neonatal complications were found between the two groups. Multivariate analysis adjusted for maternal age, parity and systemic diseases revealed that only the rates of placental abruption [OR 7.45, 95% confidence interval (CI) 2.05-26.98] and patent ductus arteriosus (OR 3.39, 95% CI 1.01-11.46) were significantly higher for the ART group.

Conclusions: Twin pregnancies conceived via ART are at greater risk of poorer outcomes than spontaneous twin pregnancies. This may be related to the type of conception and specific negative features of subfertile patients undergoing infertility treatment.

Keywords: Assisted reproductive techniques; Neonatal complications; Perinatal outcomes; Twin pregnancies.

Publication types

Comparative Study

MeSH terms

Abruptio Placentae / epidemiology
Adult
Birth Weight
Diabetes, Gestational / epidemiology
Female
Fertilization in Vitro
Gestational Age
Humans
Infant Mortality
Infant, Newborn
Infant, Newborn, Diseases / epidemiology
Postpartum Hemorrhage / epidemiology
Pregnancy
Pregnancy Outcome*
Pregnancy, Twin*
Premature Birth / epidemiology
Reproductive Techniques, Assisted*
Sperm Injections, Intracytoplasmic
Stillbirth / epidemiology