73 Pregnancy outcome in spontaneous twins versus those conceived through in vitro fertilization

OBJECTIVE: To compare maternal and neonatal complications in natural twins to those of in vitro fertilization (1VF) conceived twins.STUDY DESIGN: Twin gestations delivered from 1995 to 2000 were reviewed.Cases (N = 56) consisted of IVF twins and controls (N = 165) comprised spontaneous twins.They were compared regarding various maternal and neonatal complications.RESULTS: Maternal age was significantly higher and frequency of multiparity lower in cases compared to controls (31 _+ 5 vs 29 _+ 5 years; P= .010and 21.4% vs 62.4%; P = .000),respectively.The cesarean delivery rate was significantly higher in cases (76.8 vs 56.4%; P .011)despite similar indications and incidence of non-vertex presenting twin A in both groups.Maternal hospir, d stay was significantly longer in cases (11 _+ 15 vs 6 + 9 days; P = .003).Preterm labor (51.8 vs 21.1%; P -.000) and preterm delivery rates (67.9 vs 41.8%; P-.002) were significantly higher in cases with a significantly lower gestational age at delivery (35 _+ 3 vs 36 _+ 3 weeks; P .032).The incidence of preeelan-tpsia was 1t).7% in cases compared to 4.2% in controls (P= .147).The incidence of placental abruption, previa and diabetes were similar in both group.Both twins were on the average ~200 grains lighter in cases compared to controls and this was statistically significant.However, intrauterine growth restriction was more fi'equent in controls (36.4 vs 25.0%: P = .037).There was a significantly higher incidence of neonatal intensive care unit admission, respiratoly distress syndrome, need for nmchanical ventilation, and pneumothorax in cases vs controls; however, mean Apgar scores at 1 and 5 minntes and incidence of intraventricular heinon'hage, necrotizing enterocolitis, anomalies, sepsis and perinatal mortality rates were similar in the 2 groups.CONCLUSION: IVF twins are more likely to have a cesarean delivery, longer maternal hospital stay, higher incidence of preterm delivery and neonatal prematurity-related respiratory complications, and a longer nurser), stay.