Obstetrics and perinatal outcomes of dichorionic twin pregnancy following ART compared with spontaneous pregnancy

Abstract

Introduction:Regarding to the recent advances in assisted reproductive techniques (ART), twin and multiple pregnancies have increased during past years. Objective:This study was performed to compare obstetrics and perinatal outcomes of dichorionic twin pregnancy following ART with spontaneous pregnancy. Materials and Methods:In this cross-sectional study which was performed in Ghaem Hospital, Mashhad University of Medical Sciences, 107 dichorionic twin pregnancy were enrolled in two groups: spontaneous group (n=96) and ART group (n=31). Basic criteria and obstetrics and neonatal outcomes information including demographic data, gestational age, mode of delivery, pregnancy complications (preeclampsia, gestational diabetes, preterm labor, and intrauterine growth retardation (IUGR), postpartum hemorrhage), neonatal outcomes (weight, first and fifth minute Apgar score, Neonatal Intensive Care Unit (NICU) admission, mortality, respiratory distress, and icterus) were recorded using a questionnaire.Results:Preterm labor, gestational diabetes, and preeclampsia were significantly higher in ART group compared to spontaneous pregnancy group. However, other factors such as anemia, IUGR, postpartum hemorrhage, and intrauterine fetal death (IUFD) were not significantly different between groups. There were no significant differences between groups in terms of neonatal outcomes (weight, 1st and 5th min Apgar score <7, NICU hospitalization, mortality, respiratory distress, and icterus). Conclusion:With regard of significantly higher poor outcomes such as preeclampsia, gestational diabetes and preterm labor in ART group, the couples should be aware of these potential risks before choosing ART.

Perinatal outcome of monochorionic and dichorionic twins after spontaneous and assisted conception: a retrospective cohort study

“…In two studies there was matching for zygosity , in another four studies only unlike‐sex pairs were included in order to select (some of) dizygotic twins and in three other studies a sub‐analysis was made on naturally conceived dizygotic twins compared with AC twins to rule out the negative effect of monochorionicity on outcome. Finally, recent publications that have only included DC twin pregnancies and a recent meta‐analysis on outcome of DC twins after assisted reproduction show that these twins are at increased risk of poor outcome, such as preeclampsia, preterm birth and cesarean section, but no significant adverse effect on neonatal outcome . In the present study we did find an increased risk of preeclampsia in DC twins after AC, but risk of preterm birth with low birthweight was increased in the spontaneously conceived DC group (without neonatal adverse effect).…”

Obstetric and perinatal outcomes of dizygotic twin pregnancies resulting from in vitro fertilization versus spontaneous conception: a retrospective study

“…Although twin pregnancies are known to be related to higher risks of maternal and fetal complications than singleton pregnancies in natural conception (Qin et al, 2015; Rao, Sairam & Shehata, 2004), it is not yet clear whether twin pregnancies following IVF treatments are associated with higher risks of obstetric and neonatal conditions when compared with SC twin pregnancies. Several studies have been performed to explore the exact role of IVF-ET in obstetric and neonatal outcomes of twin pregnancies, but the results remain conflicting (Geisler et al, 2014; Helmerhorst et al, 2004; McDonald et al, 2005; Pourali et al, 2016; Qin et al, 2015; Sun et al, 2016; Vasario et al, 2010). One of the confounding factors in some studies is that monochorionicity among IVF-conceived twin pregnancies is quite rare, when compared with that in SC twin pregnancies (about 2% and 22%, respectively), and monochorionic pregnancies have more adverse effects on obstetric outcomes (Penava & Natale, 2004).…”

Maternal and perinatal outcome following assisted reproductive technology in a tertiary care centre: a retrospective study

“…This could be due to their small sample size and lower number of preterm deliveries as compared to present study. 15 Also, around three quarters of the babies (75.68%) needed NICU care in present study, mainly due to preterm birth and low birth weight. Similarly, high rates of NICU requirement were seen in studies done by Caserta et al…”