Maternal and Perinatal Outcomes in Spontaneous Twins versus Twins Conceived By Ovulation Induction and Assisted Reproductive Techniques: A Cross-Section Study

Twin pregnancies have a higher perinatal mortality and morbidity and increased obstetrical complications compared with singleton pregnancies, and assisted reproduction techniques (ART) have increased twin pregnancy rates. This study was performed to compare perinatal and obstetric outcomes of dichorionic twin pregnancy following ART with those from spontaneous pregnancy. This cross-sectional study was performed in the Erbil Maternity Teaching Hospital. Two-hundred dichorionic twin pregnancies were classified into two groups: spontaneous (n = 121) and ART (n = 79) groups. Basic criteria included demographic data, gestational age, mode of delivery, pregnancy complications (preeclampsia, gestational diabetes, preterm labor, anemia, blood transfusion, postpartum hemorrhage), neonatal outcomes (weight, first and fifth minute Apgar score, neonatal intensive care unit admission, respiratory distress, and sepsis). The rates of pregnancy induced by hypertension, gestational diabetes, and pre-labor preterm rupture of membrane were significantly higher in the ART group, but postpartum hemorrhage, blood transfusion, anemia, were not significantly different. The majority of women in the ART group delivered by caesarean section. The risks of preterm birth, low neonatal birth weight and congenital malformation, and moderately depressed Apgar scores were higher in the ART group, while no significant differences were detected regarding other outcomes. In our study, the second twin had a worse outcome compared with the first twin in both groups of conception. Maternal and neonatal outcomes were poorer in the ART group. The second twin had a worse outcome compared with the first twin in both groups.