Maternal and perinatal outcomes in twin pregnancies conceived spontaneously and by assisted reproductive techniques: cross-sectional study.

Abstract

Data vary on maternal and perinatal outcomes of twin pregnancies conceived through assisted reproductive technology compared with spontaneous conception. This study compared maternal, perinatal and obstetric outcomes of dichorionic twin pregnancies conceived spontaneously with twin pregnancies conceived through assisted reproductive technology. This was a cross-sectional study of dichorionic twins delivered at the Maternity Teaching Hospital, Erbil, Kurdistan Region, Iraq from 1 November 2016 to 31 December 2017. Twin pregnancies were classified into two groups: spontaneously conceived (n = 121) and conceived through assisted reproductive technology (n = 79). Maternal and perinatal outcomes were compared between the two groups. The chi-squared test was used to compare categorical variables and the Student t-test to compare means. Logistic regression analysis was used to assess factors associated with admission to the neonatal intensive care unit. Pregnancy-induced hypertension, gestational diabetes and preterm rupture of membranes were more common in mothers in the assisted reproductive technology group (P < 0.05). Preterm birth, low neonatal birth weight and congenital malformation were also more common in the assisted reproductive technology group (P < 0.001). Gestational age < 33 weeks and conception through assisted reproductive technology were significantly associated with admission to the neonatal intensive care unit for both twins. Studies are needed to assess the reasons for the differences in perinatal and maternal outcomes between twin pregnancies conceived spontaneously and through assisted reproductive technology.