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

Abstract

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.

Keywords

• assisted reproductive technology
• perinatal outcomes
• twin pregnancy