Obstetrics And Perinatal Outcomes Of Twin Pregnancies After Assisted Reproduction Technology Compared With Spontaneous Pregnancy

Objective:To compare obstetrics and perinatal outcomes in dichorionic diamnionic twin pregnancies through assisted reproduction technology(ART)with natural conception.At the same time,to explore the impact of advanced maternal age on obstetrics and neonatal outcomes in the group of ART.The aim of this study is to provide evidence for reducing perinatal complications after assisted reproductive technology.Methods: We retrospectively analyzed the clinical data of 135 women of dichorionic diamnionic twin pregnancies in the first Affiliated Hospital of Chongqing Medical University from January 2014 to October 2016.According to the different mode of conception,the patients were divided into ART group(n=56)and spontaneous conception group(n=79).Results:(1)The patients' age,the proportion of primipara,the times of delivery were significantly different between the two groups.There was no significant difference in the rate of cesarean section and the times of pregnancy.(2)The rates of intrahepatic cholestasis of pregnancy(ICP),placenta previa and postpartum hemorrhage were significantly higher in dichorionic twin pregnacies after ART.However,other factors such as abortion,gestational diabetes mellitus(GDM),hypertensive disorders in pregnancy,premature rupture of membrane(PROM),placental abruption were no significantly different between the two groups.(3)The birth weight of ART group is higher than the spontaneous pregnancy group,the difference was statistically significant.There were no significant differences between groups in terms of congenital malformations,stillbirth,neonatal asphyxia,low birth weight infants,very low birth weight infants,the proportion of male and female infants.(4)GDM was higher in elderly pregnant women after ART,the difference existed statistically significant.The birth weight was lower in elderly pregnant women than younger age group,the difference was statistically significant.The times of delivery,proportion of primipara,cesarean section rate,hypertensive disorders in pregnancy,placenta previa,PROM,ICP,premature delivery,postpartum hemorrhage were no significant difference between elderly and young pregnancy women.Conclusion(s):(1)Multiple embryo transfer can increase the perinatal complications of dichorionic diamniotic twin pregnancies.(2)Assisted reproductive technology is closely related to the increase of pregnancy complications.(3)The advanced age of mother(aged over 35 years old)is one of the important factors associated with increased complications during pregnancy.