Taiwanese Journal of Obstetrics and Gynecology
Volume 44, Issue 4 , Pages 332-337, December 2005

Twin Pregnancies Conceived by Assisted Reproductive Technology: Maternal and Perinatal Outcomes

Department of Obstetrics and Gynecology, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan

Received 13 July 2005; received in revised form 13 July 2005; accepted 14 July 2005.

Article Outline

Summary 

Objective

To determine whether twin pregnancies conceived by assisted reproductive technology (ART) are at increased risk of obstetric complications or perinatal morbidity.

Methods

This was a retrospective hospital-based cohort study of all twin pregnancies delivered at 23 or more weeks of gestation between January 1, 2002 and December 31, 2003. The obstetric and neonatal outcomes of twins conceived by ART were compared with the outcomes of those conceived by ovulation induction or spontaneously.

Results

There were 74 twin pregnancies following ART, 31 following ovulation induction and 54 following spontaneous conception. Mean maternal age was significantly higher in the ART group than in the spontaneous group. Mean gestational age and the percentage of pregnancy complications were comparable among groups. There was no significant difference in mean birth weight. The incidences of congenital anomaly, neonatal hypoglycemia, ventilator use, and perinatal death and duration of neonatal intensive care unit (NICU) admission were significantly higher in the spontaneous group. The percentage of dichorionic pregnancies in the ART group was significantly higher than that in the spontaneous group. The perinatal outcome in dichorionic ART and spontaneous twins was comparable. The incidence of pregnancy complications, NICU admission and perinatal death were comparable in reduced and non-reduced twin pregnancies.

Conclusions

ART-conceived twin pregnancies are not at greater risk for pregnancy complications and adverse perinatal outcome than non-ART-conceived twin pregnancies. Chorionicity is probably an important factor for adverse perinatal outcome. Reduced and non-reduced twin pregnancies are comparable in obstetric and neonatal outcomes.

Key Words:  assisted reproductive technology , perinatal outcomes , twin pregnancy

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References 

  1. Jewell SE , Yip R . Increasing trends in plural births in the United States . Obstet Gynecol . 1995;85:229–232
  2. Conde-Agudelo A , Belizan JM , Lindmark G . Maternal morbidity and mortality associated with multiple gestations . Obstet Gynecol . 2000;95:899–904
  3. Daniel Y , Ochshorn Y , Fait G , Geva E , Bar-Am A , Lessing JB . Analysis of 104 twin pregnancies conceived with assisted reproductive technologies and 193 spontaneously conceived twin pregnancies . Fertil Steril . 2000;74:683–689
  4. Zuppa AA , Maragliano G , Scapillati ME , Crescimbini B , Tortorolo G . Neonatal outcome of spontaneous and assisted twin pregnancies . Eur J Obstet Gynecol Reprod Biol . 2001;95:68–72
  5. Nyirati I , Orvos H , Bartfai G , Kovacs L . Iatrogenic multiple pregnancy. Higher risk than a spontaneous one? . J Reprod Med . 1997;42:695–698
  6. Olivennes F , Kadhel P , Rufat P , Fanchin R , Fernandez H , Frydman R . Perinatal outcome of twin pregnancies obtained after in vitro fertilization: comparison with twin pregnancies obtained spontaneously or after ovarian stimulation . Fertil Steril . 1996;66:105–109
  7. Zaib-un-Nisa S , Ghazal-Aswad S , Badrinath P . Outcome of twin pregnancies after assisted reproductive techniques-a comparative study . Eur J Obstet Gynecol Reprod Biol . 2003;109:51–54
  8. Bernasko J , Lynch L , Lapinski R , Berkowits RL . Twin pregnancies conceived by assisted reproductive techniques: maternal and neonatal outcomes . Obstet Gynecol . 1997;89:368–372
  9. Kozinszky Z , Zadori J , Orvos H , Katona M , Pal A , Kovasc L . Obstetric and neonatal risk of pregnancies after assisted reproductive technology: a matched control study . Acta Obstet Gynecol Scand . 2003;82:850–856
  10. Ochsenkühn R, Strowitzki T, Gurtner M, Strauss A, Schulze A, Hepp H, et al. Pregnancy complications, obstetric risks, and neonatal outcome in singleton and twin pregnancies after GIFT and IVF . Arch Gynecol Obstet . 2003;268:256–261
  11. Minakami H , Sayama M , Honma Y , et al.   Lower risks of adverse outcome in twins conceived by artificial reproductive techniques compared with spontaneously conceived twins . Hum Reprod . 1998;13:2005–2008
  12. Bergh T , Ericson A , Hillensjö T , Nygren K-G , Wennerholm U- B . Deliveries and children born after in vitro fertilization in Sweden, 1982–95: a retrospective cohort study . Lancet . 1999;354:1579–1585
  13. Dodd J , Crowther C . Multifetal pregnancy reduction of triplet and higher-order multiple pregnancies to twins . Fertil Steril . 2004;81:1420–1422
  14. Evans MI , Kaufman MI , Urban AJ , Britt DW , Fletcher JC . Fetal reduction from twins to a singleton: a reasonable consideration? . Obstet Gynecol . 2004;104:102–109

PII: S1028-4559(09)60166-2

doi:10.1016/S1028-4559(09)60166-2

Taiwanese Journal of Obstetrics and Gynecology
Volume 44, Issue 4 , Pages 332-337, December 2005

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