Maternal characteristics and twin gestation outcomes over 10 years: impact of conception methods
Christian Bamberg1, Christina Fotopoulou, Philipp Neissner
1Department of Obstetrics, Charité University Medical Center, Berlin, Germany. christian.bamberg@charite.de
Objective:
To compare maternal characteristics and obstetric outcomes of spontaneously conceived (SC) and after-fertility treatment (FT) twins.
Design:
Retrospective study.
Setting:
Single tertiary center (university hospital).
Patient(S):
All twin pregnancies (n = 1,239) delivered ≥ 24 weeks of gestation and classified by the mode of conception.
Intervention(S):
None.
Main Outcome Measure(S):
Maternal age, prematurity, preterm rupture of membranes (PROM), delivery mode, cervical insufficiency, preeclampsia/HELLP (hemolysis, elevated liver enzymes, low platelet count) syndrome, gestational diabetes, and postpartum hemorrhage.
Result(S):
Of 1,239 mothers evaluated, 34.4% received FT. We observed a continuous 3.2-year mean increase in maternal age over time in the FT population. The FT group had statistically significantly higher rates of women ≥ 35 years of age versus the SC group (37.6% vs. 22.9%). Mean maternal age (32.5 vs. 30.1 years) and the rates of cesarean delivery (72.3% vs. 63.9%), dichorionic twin prematurity (67.7% vs. 59.6%), postpartum hemorrhage (9.9% vs. 6%), PROM (2.3% vs. 0.6%), and cervical insufficiency (17.6% vs. 10%) were statistically significantly higher in the FT group. Preeclampsia/HELLP syndrome and gestational diabetes showed no significantly significant difference.
Conclusion(S):
Mothers of twins after FT were statistically significantly older and had higher rates of prematurity, cesarean delivery, and obstetric morbidity.
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