Obstetrics and perinatal outcomes in multiple pregnancies conceived with assisted reproduction techniques.

Abstract

The results of studies comparing obstetric and perinatal evolution of ART twins versus spontaneously-conceived twins are controversia. We performed a retrospective case-control study of 148 multiple pregnancies monitored at the University Hospital of the Canary Islands during 1996-2002. Of these, 72 were conceived after ovarían stimula­tion and ART treatment, considered as the study group, while 76 were spontaneously conceived, considered as the control group. Mean maternal age (33.3± 4.35 vs 30.0± 4.56, p<0.001) and the number of women >35 years were significantly higher in the ART group than in the spontaneous group (74.2% vs 25.8%, p<0.001). The percentage of women with pregnancy complications was higher in the ART group (34.7% vs 21.1 %, p<0.04), as was the percentage of complications such as increased risk of preterm delivery (12.5% vs 11.8%), preeclampsia (6.9% vs 3.9%), uterine bleeding (2.8% vs 1.3%), and diabetes (12.5% vs 3.9%). Mean gestational age was significantly lower in the study group than in the control group and the percentage of women who delivered before 34 weeks' gestation was significantly higher (34.87 vs 35.97, p<0.05). Cesarean section rate was higher in the ART group than in the spon­taneous group (88.8% vs 69.7%, p<0.01). Mean birth-weight was not significantly different between the groups (2213.36 vs 2216.26 gr.), nor was the 5-minute Apgar score of <7 (6.0% vs 8.6%). In conclusion, the women with multiple pregnancies conceived by assisted reproductive techniques were older, had more complications during pregnancy, had more preterm deliveries and were more likely to undergo elective caesarean delivery, although neonatal outcomes were comparable with those of spontaneously conceived newborns.