Maternal and neonatal complications of twin pregnancy in different modes of conception / 中华实用儿科临床杂志

ABSTRACT

Objective To explore the differences in maternal and neonatal complications of twin pregnancies in different modes of conception.Methods Retrospective analysis was performed to compare the differences in mother's gestation history,childbirth and neonatal complications among 102 cases of in vitro fertilization-embryo transfer(IVFET) pregnancy twins,16 cases of simple ovulation induction(OI) pregnancy twins and 96 cases of spontaneous conception(SC) pregnancy twins.Results 1.The maternal age[(32.51 ±4.03) years vs (31.25 ±3.38) years vs (30.20 ± 4.13) years,F =8.061,P ＜ 0.05] and birthrate of full-term infants (21.5 ％ vs 0 vs 10.4％,x2 =7.566,P ＜ 0.05) of IVF-ET group were significantly higher than that of OI group and SC group.The body weight at birth of OI group was significantly lower than that of IVF-ET group and SC group [(1 918.1 ±516.4) g vs (2 228.3 ±4542) g vs (2 164.4 ±442.5) g,F =3.293,P ＜0.05].The birthrate of late preterm infant(87.5％ vs 51.0％ vs 64.6％,x2 =9.322,P ＜ 0.05) and the incidence of twin discordance (50.0％ vs 21.6％ vs 18.8％,x2 =7.781,P ＜ 0.05) of OI group were significantly higher than that of IVF-ET group and SC group,while the incidence of monozygotic twins of SC group was significantly higher than that of IVF-ET group and OI group(52.1％ vs 5.9％ vs 0,x2 =58.016,P ＜ 0.05).2.The incidence of pregnancy induced hypertension of OI group was significantly higher than those of IVF-ET group and SC group(50.0％ vs 17.6％ vs 22.9％,x2 =8.344,P ＜ 0.05).The incidence of gestational diabetes mellitus of OI group and spontaneous group was significantly higher than that of IVF-ET group(12.5％ vs 14.6％ vs 3.9％,x2 =6.838,P ＜0.05).3.The incidence of twin transfusion syndrome of SC group was significantly higher than that of the other groups(6.3％ vs 0 vs 0,x2 =7.588,P ＜0.05),but the incidence of apnea of prematurity of OI group was significantly higher than that of IVF-ET group and SC group(43.8％ vs 15.7％ vs 24.0％,x2 =7.081,P ＜0.05).The incidence of asphyxia,transient tachypnea of the newborn,hypoglycemia,intracranial hemorrhage and septicemia of OI group were higher than that of IVF-ET group and SC group,but there was no significantly difference among 3 groups.Conclusions IVF-ET conceived twin pregnancies are not at greater risk for pregnancy complications and adverse perinatal outcome than SC twin pregnancies.But the incidence of some adverse maternal and neonatal complications of simple OI twin pregnancies is higher than that of IVF-ET group and SC group.More attention should be paid to the perinatal health care of OI conception twins,which is important to avoid serious complications.