A Statistical Analysis of Obstetric and Perinatal Complications in Singleton and Multiple Pregnancies Once Assisted Reproductive Technologies Are Used

Abstract

The aim: To carry out a comparative statistical analysis of obstetric and perinatal complications in singleton and multiple pregnancies once assisted reproductive technologies (ART) are applied according to the records taken from archival materials (maternity and delivery records) and identify the clinical features of multiple pregnancy. Materials and methods: Over the period of 2017-2019, 522 women gave birth in LELEKA Maternity Hospital LLC after using assisted reproductive technologies and 331 women among them were followed-up in the women’s health center of LELEKA maternity hospital. Among these women (522) with singleton pregnancy 445 women gave birth, while in multiple pregnancy – 77. The statistical analysis of 150 maternity and delivery records was carried out. All pregnant women were divided into two groups: group 1 – 75 women having singleton pregnancy after ART; group 2 – 75 women having multiple pregnancy after ART. Women getting pregnant after ART, or in vitro fertilization (IVF) and five-day frozen embryo transfer to be exact, turned out to be the selection criterion for a comparative statistical analysis. Mathematical methods for research were used as O.P. Mintser (2013) suggested. The reliability of the digit cancellation test was calculated using the Fisher’s exact test and Student’s T-test. Graphs were designed using Microsoft Excel. Results: The complications of early multiple pregnancy were the following: anemia (47.8% as opposed to 22.9%, p<0.01), placental insufficiency (43.3% in contrast to 22.9%, p<0.01), threatened abortion (41.8% in contrast to 28.6%, p<0.01). The complications in late pregnancy are as follows: preeclampsia (52.7% as opposed to 20.6%, p <0.01), intrauterine growth restriction (20.0% as opposed to 7.4%, p <0.01), anemia in pregnancy (76.4% in contrast to 32.4%, p<0.01), placental insufficiency (47.3% in contrast to 22.1%, p<0.05). Conclusions: Multiple pregnancy is a high risk for anemia in pregnancy, preeclampsia, placental insufficiency, early intrauterine growth restriction and fetal distress in pregnancy and labor. It predetermines the high level of a caesarean section. Therefore, further research aimed at prediction and prevention of obstetric and perinatal complications in multiple pregnancy after ART is currently topical.

Clinical and laboratory key performance indicators in IVF: A consensus between the Italian Society of Fertility and Sterility and Reproductive Medicine (SIFES-MR) and the Italian Society of Embryology, Reproduction and Research (SIERR)

“…Women with a twin pregnancy are 6 times more likely to be hospitalized with complications, especially when of advanced maternal age. Multiple pregnancy is associated with high gestational risks (2-threefold increase versus singletons) including prematurity (17% of all preterm birth; sixfold increase), low birthweight (24% of low birth-weight infants < 2,500 g and 26% of very-low-birth-weight < 1,500 g), hypertensive pregnancy disorders (3-fourfold increase), gestational diabetes, postpartum hemorrhage, premature rupture of the membranes, hyperemesis, severe anemia, operative delivery, neonatal morbidity and high neonatal and infant mortality [55,56]. Therefore, a single blastocyst transfer is strongly recommended to ensure safety to all infertile couples, and especially in advanced maternal age women undergoing PGT-A or egg donation cycles, to reduce the prevalence of multiple pregnancies [57].…”