Authors:
Alexandra J. Bensdorp, M.D., Chantal W. Hukkelhoven, Ph.D., Fulco van der Veen, Ph.D., Ben W.J. Mol, M.D., Ph.D., Nils C.B. Lambalk, M.D., Ph.D., Madelon van Wely, M.D., Ph.D.
Abstract:
Objective:
To compare maternal and perinatal outcomes in dizygotic twin pregnancies conceived after medically assisted reproduction (MAR) with outcomes after natural conception (NC).
Design:
Nationwide registry based study.
Setting:
Academic medical center.
Patient(s):
Primiparous women who delivered opposite sex twins between January 2000 and December 2012 in the Netherlands, comprising dizygotic twin pregnancies: 6,694 women, 470 after ovulation induction (OI), 511 after intrauterine insemination with controlled ovarian hyperstimulation (IUI-COH), 2,437 after in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI), and 3,276 after NC.
Intervention(s):
None.
Main Outcome Measure(s):
Multivariable logistic regression and generalized linear mixed models to evaluate differences in outcomes: maternal outcomes of hypertension, preeclampsia, preterm delivery, hemorrhage, and delivery mode, perinatal outcomes including small for gestational age (SGA) with birth weight Result(s):
We found no statistically significant differences in maternal or perinatal outcomes after OI compared with NC. Women pregnant after IVF-ICSI had a lower risk for hypertension (adjusted odds ratio [aOR] 0.74; 95% confidence interval [CI], 0.66–0.83) compared with women pregnant after NC. After IUI-COH more children had Apgar scores Conclusion(s):
Overall, maternal and perinatal risks other than those due to multiplicity are similar for twin pregnancies conceived after MAR and after NC.
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