A Comparison of Perinatal Outcomes in Multiple Pregnancies: Assisted Versus Spontaneous Conception: A Cross-Sectional Study

Abstract

Objective: To investigate the difference in perinatal and delivery outcomes in multiple pregnancies, depending on mode of conception. Design: An observational cross sectional study. Setting: Homerton University Hospital NHS Foundation Trust, a University Hospital in London. Sample: All multiple pregnancies delivered at the hospital between the inclusive years 2009-2012 were reviewed with a total of 341 pregnancies included. Methods: Maternal demographics and perinatal outcomes including mortality rates, were collected on all participants. Main outcome measures: Maternal demographics including age and length of postnatal hospital stay, pregnancy outcomes including mode of delivery, and perinatal outcomes including mortality rates. Results: Women who conceived naturally were significantly younger (30.42 ± 5.98 years) than those conceived through assisted treatment (34.24 ± 5.73 years; p<0.05). Babies conceived through assisted treatment were born at a significantly lower gestational age (33.81 ± 4.05 weeks) than those conceived spontaneously (34.81 ± 3.55 weeks; p<0.05). The average birth weight was significantly lower in those conceived by assisted treatment as compared to those conceived naturally. More naturally conceiving women delivered by spontaneous vaginal delivery (23.9%) as compared to those conceived by assisted treatment (9.2%, p<0.05). Conclusions: Comparable perinatal mortality rates are seen between twins conceived naturally and those conceived by assisted reproductive technology; however significantly lower gestational age, birth weight and vaginal delivery rates were seen in pregnancies conceived by assisted treatment.