| Objective To compare the maternal and infant outcomes of assisted reproductive technology(ART)assisted pregnancy and naturally conceived twin pregnancy,to clarify the impact of ART on twin pregnancy;and to explore the high risk factors for common obstetric complications in ART-assisted twin pregnancy.Lay a theoretical foundation for improving maternal and infant safety in ART twin pregnancy.Methods The clinical data of 430 pregnant and lying-in women and perinatal infants with Dichorionic diamniotic(DCDA)who underwent regular obstetric examination and delivered in the obstetrics department of Maternal and Child Health Hospital of Inner Mongolia Autonomous Region from January 2018 to June 2021 were retrospectively analyzed.178 cases of ART-assisted twin pregnant women and their 356 cases were set as the observation group,and 252 cases of naturally conceived twin pregnant women and their 504 cases were set as the control group.Complications and perinatal outcomes;430 research subjects were further stratified into older and younger groups according to their advanced age,and the two groups of pregnant women were compared between the observation group and the control group.At the same time,in order to improve the maternal and infant safety of ART twin pregnancy,multivariate Logistic regression was used to analyze the common obstetric complications of preterm birth and postpartum hemorrhage(PPH)high risk factors in ART twins.Results 1.The age,pre-pregnancy body mass index,as well as the proportion of advanced age,obesity/overweight,excessive weight gain during pregnancy,previous adverse pregnancies and primiparas in the observation group were higher than those in the control group,and the difference between the two groups was statistically significant;There was no significant difference in the number of pregnancies,gestational age at delivery,and cesarean section rate,and the cesarean section rate between the two groups was over 95%.2.The incidence rates of gestational diabetes mellitus,gestational hypertension,preeclampsia,placenta previa,intrahepatic cholestasis of pregnancy and PPH in the observation group were higher than those in the control group,and the differences were statistically significant;There was no significant difference in the incidence rates of premature rupture of membranes,placental abruption,anemia during pregnancy and preterm birth,and the preterm birth rate between the two groups was >50%.3.The birth weight of newborns in the observation group was lower than that in the control group,and the incidence of low birth weight infants and twins with inconsistent growth was higher than that in the control group,and the differences were statistically significant.There were no statistically significant differences in fetal sex ratio,neonatal respiratory distress syndrome,and congenital malformations between the two groups.4.After stratification according to advanced age,the comparison results between the advanced age groups showed that the incidence of gestational hypertension-related diseases and placenta previa in the observation group was higher than that in the control group,and the difference was statistically significant;the other two groups had perinatal complications There was no statistically significant difference between the two groups.The comparison results between the younger age groups showed that the incidence rates of gestational diabetes mellitus,gestational hypertension-related diseases,intrahepatic cholestasis of pregnancy,PPH,low birth weight infants and twins in the observation group were higher than those in the control group,and the differences were statistically significant.There were no significant differences in perinatal complications and perinatal conditions between the remaining two groups.5.Multivariate Logistic regression analysis showed that advanced age,overweight/obesity,gestational hypertension,and preeclampsia all increased the risk of preterm birth in ART twins.6.Multivariate Logistic regression analysis showed that advanced age,overweight/obesity,excessive weight gain during pregnancy,gestational hypertension,preeclampsia,and placenta previa all increase the risk of PPH in ART twins.Conclusion 1.Combination of advanced age,obesity/overweight,excessive weight gain during pregnancy,previous adverse pregnancies and primiparas in ART twin pregnancies is more common than naturally conceived twins,and twin pregnancies tend to be more common regardless of the method of conception.opt for surgical termination of pregnancy.2.The probability of gestational diabetes mellitus,gestational hypertension,preeclampsia,placenta previa,intrahepatic cholestasis of pregnancy and PPH in ART twin pregnancies is higher than that in naturally conceived twins,and the difference between the two methods of conception is higher.The risk of premature delivery of twins is greatly increased,so clinicians should strengthen the monitoring and management of such groups during pregnancy.3.The incidence of neonatal low birth weight and twin growth inconsistency in ART twin pregnancy is significantly higher than that in naturally conceived twins,so ART twins should undergo regular ultrasound examinations to understand the intrauterine growth status and give active interventions measure.4.The occurrence of gestational hypertension-related diseases and placenta previa is common in older women in ART twin pregnancy;gestational diabetes mellitus,gestational hypertension-related diseases,and intrahepatic gestational hypertension are common in younger women in ART twin pregnancy.Higher risk of cholestasis,PPH,low birth weight,and discordant twin growth.5.Advanced age,overweight/obesity,and gestational hypertension are all important risk factors for preterm birth in ART twin patients.6.Advanced age,overweight/obesity,excessive weight gain during pregnancy,gestational hypertension,and placenta previa are important risk factors for PPH in ART twins. |
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