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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2018

Open Access 01-12-2018 | Research article

Neonatal outcomes among twins following assisted reproductive technology: an Australian population-based retrospective cohort study

Authors: Alex Y. Wang, Nadom Safi, Fathalla Ali, Kei Lui, Zhuoyang Li, Mark P. Umstad, Elizabeth A. Sullivan

Published in: BMC Pregnancy and Childbirth | Issue 1/2018

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Abstract

Background

While their incidence is on the rise, twin pregnancies are associated with risks to the mothers and their babies. This study aims to investigate the likelihood of adverse neonatal outcomes of twins following assisted reproductive technology (ART) compared to non-ART twins.

Methods

A retrospective population study using the Australian National Perinatal Data Collections (NPDC) which included 19,662 twins of ≥20 weeks gestational age or ≥ 400 g birthweight in Australia. Maternal outcomes and neonatal outcomes (preterm birth, low birth weight, resuscitation and neonatal death) were compared. Generalized Estimating Equations were used to assess the likelihood of any neonatal outcomes, with adjusted odds ratio (AOR) and 95% confidence intervals (CI) presented. Weinberg’s differential rule was used to estimate monozygotic twin rate.

Results

ART mothers were 3.3 years older than non-ART mothers. The rates of pregnancy-induced hypertension and gestational diabetes were significantly higher for ART mothers than non-ART mothers (12.2% vs. 8.4%, p <  0.01) and (9.7% vs. 7.5%, p <  0.01) respectively. The incidence of monozygotic twins was 2.0% for ART twins and 1.1% for non-ART twins. Compared with non-ART twins, ART twins had higher rates of preterm birth (AOR 1.13, 95% CI: 1.05–1.22), low birth weight (AOR 1.13, 95% CI: 1.05–1.22), and resuscitation (AOR 1.26, 95% CI: 1.17–1.36). Liveborn ART twins had 28% (AOR 1.28, 95% CI 1.09–1.50) increased odds of having any adverse neonatal outcome compared to liveborn non-ART twins, especially for opposite-sex ART twins (AOR 1.42, 95% CI 1.11–1.82).

Conclusion

As ART twins had higher rates of adverse outcome, special prenatal care is recommended. Couples accessing ART should be fully informed of the risk of adverse outcome of twin pregnancies.
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Metadata
Title
Neonatal outcomes among twins following assisted reproductive technology: an Australian population-based retrospective cohort study
Authors
Alex Y. Wang
Nadom Safi
Fathalla Ali
Kei Lui
Zhuoyang Li
Mark P. Umstad
Elizabeth A. Sullivan
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2018
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-018-1949-0

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