Obstetric and perinatal outcomes in twin pregnancies conceived through assisted reproduction: A retrospective cohort study.

Abstract

Introduction. Multiple pregnancies are more frequently associated with adverse maternal and neonatal outcomes. The incidence of multiple pregnancies has increased with the use of assisted reproductive technologies (ART): they account for between 15% and 25% of twin births. ART has also been associated with adverse outcomes in both singleton and multiple pregnancies, although the available evidence is limited and heterogeneous. Objective. To evaluate maternal and perinatal outcomes in spontaneously conceived twin pregnancies and compare them with those conceived through ART. Population and methods. Patients aged 18 years or older with twin pregnancies who reached a gestational age of 24.0 weeks and who underwent first-trimester screening, follow-up, and delivery at the Hospital Italiano de Buenos Aires between January 2014 and December 2022. A composite outcome of maternal and neonatal adverse events was analyzed. Neurological development was monitored until age 2. Results. A total of 243 twin pregnancies were included (148 ART; 95 spontaneous). The ART group had a higher prevalence of advanced maternal age, nulliparity, obesity, and chronic diseases, with statistically significant differences (p <0.001). There were no significant differences in primary maternal outcomes (29% vs. 23%; p = 0.347) or neonatal outcomes (16% vs. 19%; p = 0.371). We found an increased frequency of autism spectrum disorders in pregnancies conceived through ART. Conclusion. Twin pregnancies resulting from ART showed similar maternal and neonatal outcomes to those resulting from spontaneous conception, despite significant differences in baseline maternal characteristics. Long-term follow-up studies are needed.