Clinical Outcomes Of Twin Pregnancy Conceived By Assistant Reproductive Technology And Spontaneous Twin Pregnancy

Objective:To figure out whether there is any difference in clinical outcomes between assistant reproductive technology(ART)twins and naturally conceived twins,and to analyze the possible related factors which may lead to death.Methods:188 twins conceived by reproductive technology(ART group)and 522 naturally conceived twins(control group)are included.Pregnancy complications,birth condition,neonatal diseases,birth defects are compared between each group.The influencing factors which may lead to neonatal death are analyzed by the Cox’s regression analysis.Results:Mothers’age in the ART group were older,their gestational weeks were shorter,and the incidence of twin-twin transfusion syndrome(TTTs)in the control group was higher than ART group(P<0.05).Compared with control group,the proportion of ART group borned by cesarean section and premature babies was higher(P<0.05).There was no significant difference in the incidence of congenital heart disease(CHD),gastrointestinal malformations,and urinary system malformations in the ART group compared with naturally the control group(P>0.05),but the incidence of the musculoskeletal abnormalities in ART group was higher than that in the control group(P<0.05).Compared with the control group,the incidence of coagulation dysfunction,respiratory failure,neonatal diseases,renal dysfunction,and feeding intolerance in the neonatal period of the ART group increased(P<0.05).Cox’s regression analysis showed that low birth weight was a risk factor for neonatal death(P<0.05).Conclusion:This study shows that the incidence of musculoskeletal abnormalities in ART twins and neonatal coagulation dysfunction,respiratory failure,renal damage,and feeding intolerance are higher than those of naturally conceived twins.For ART twins,attention should be paid to their blood coagulation function and kidney function.Strengthen the management of their respiratory and digestive system,strengthen the nutrition management during pregnancy,increase the birth weight of the newborn,avoid premature delivery,which may reduce the mortality of neonates.