Analysis Of Clinical Characteristics And Outcomes Of Twin Premature Infants Conceived In ART During The Neonatal Period

Objective:Through collecting the relevant clinical data of twin premature infants and their pregnant mothers.To retrospectively analyze the differences of clinical characteristics and perinatal disease characteristics between assisted reproductive technology twins and natural conception,to provide some guidance for the clinical management of the twin premature infants of ART and the perinatal health care of mothers and infants.Method:A total of 440 twin premature infants who were delivered in the obsteric department of the Affiliated Hospital of Yan’an University from January 2019 to December 2022 and transferred to the neonatal department with a gestational age of 28-36+6 weeks were selected as participants.Depending on the different ways of conception,the twin premature infants were divided into ART group and natural conception group.The data of their mother’s demographic status,general conditions of pregnancy,complications of pregnancy,newborn birth and major diseases were collected,after which the differences between the two groups of pregnant mothers and newborns were analyzed using SPSS27.0 software.Outcome:1.Compared with the gestational age of NC group,the proportion of maternal age<25 years old in ART group is lower,and the proportion of maternal age ≥35 years old is higher.The difference between groups is statistically significant(P<0.05).The average reproductive age of pregnant women in ART group(31.16±3.93)years old was higher than that in NC group(29.61±4.37)years old,and the difference between groups was statistically significant(t=2.727,P=0.007).2.In pregnant women of ART group,the proportion of primipara was 66.3%,the proportion of spontaneous abortion was 18.9%,the use rate of antenatal glucocorticoid was 69.5%,and the incidence of oligohydramnios was 34.7%,which were higher than that of NC group 42.4%,8.0%,48.8%,22.4%,and the difference between groups was statistically significant(P<0.05).In the ART group,the proportions of pregnant mothers with scarred uterus and history of abortion were 7.4% and 10.5%,respectively,which were lower than 25.6% and 36.0% in the NC group,and all of these were also statistically significant(P < 0.05).3.Among the pregnant mothers in the ART group,the proportion of hypertension during pregnancy is higher than that of the pregnant mother of group NC,and the difference is statistically significant(P<0.05).4.During the data collection period,396 pairs of twins were born in our hospital,including 238 pairs of premature twins,with a premature delivery rate of 60.1%.5.In ART group and NC group,gestational age of twin premature infants were mainly distributed in 34-36+ 6 weeks,weight were mainly distributed in 1500-2499 g.The incidence of low birth weight in twin premature infants in ART group was higher than that in NC group,and the difference was statistically significant(P<0.05).6.The incidence of neonatal respiratory distress syndrome in twin premature infants in ART group was higher than that in NC group,and the difference was statistically significant(P<0.05).7.There was no statistically significant difference between ART group and NC group in the use of pulmonary surfactant,caffeine,antibiotics,blood products,oxygen therapy and respiratory support for twin premature infants(P>0.5).8.The mortality rate of twin premature infants in ART group was 2.1%,and that in NC group was 0.8%.The difference was not statistically significant(P>0.5).Conclusion:1.The risk of hypertension in pregnancy of mothers of twin premature infants in ART group is higher than that in natural pregnancy.Therefore,obstetricians should dynamically monitor blood pressure during pregnancy,and make early intervention to minimize the risk of complications during pregnancy.2.The median gestational age(days)and birth weight of twin premature infants in ART group were lower than those in NC group,and the mortality rate was higher than that in NC group,suggesting that the risk of admission of twin premature infants in ART group was correspondingly higher.3.Preterm twins with ART are more likely to suffer from NRDS than those with natural pregnancy,and neonatal pediatricians should pay more attention to it,strengthen the health care and management of pregnant mothers,and reduce the occurre-nce of adverse endings of newborns.