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Neurodevelopmental and cardiometabolic outcome in 4-year-old twins and singletons born after IVF
Derk Kuiper1, Anne Bennema1, Sacha la Bastide-van Gemert2
1University of Groningen, University Medical Center Groningen, Department of Paediatrics, Division of Developmental Neurology, Hanzeplein 1, Groningen GZ 9713, The Netherlands.
Insights
Four-year-old in vitro fertilization (IVF) twins showed lower IQ, weight, and height than singletons. However, these differences vanished after accounting for other factors, indicating IVF does not alter the typical twin development effect.
Area of Science:
- Developmental Psychology
- Reproductive Medicine
- Pediatrics
Background:
- Assisted reproductive technologies like in vitro fertilization (IVF) are increasingly common.
- Studies suggest potential developmental differences in twins compared to singletons.
- The impact of IVF on these twin-specific developmental trajectories requires further investigation.
Purpose of the Study:
- To compare cognitive development, neurological status, anthropometrics, and blood pressure in 4-year-old IVF twins versus IVF singletons.
- To determine if IVF influences the known developmental disparities observed in twins.
- To identify potential mediators and confounders affecting twin development.
Main Methods:
- Prospective cohort study including 103 IVF singletons and 48 IVF twins.
- Primary outcome: total intelligence quotient (IQ).
- Secondary outcomes: minor neurological dysfunction, anthropometrics (weight, height), and blood pressure.
Main Results:
- Unadjusted analyses revealed lower total IQ, weight, and height in IVF twins compared to singletons.
- Mean IQ difference was -5.4 points; twins were shorter by 2.9 cm and lighter by 1.7 kg.
- After adjusting for mediators and confounders, all significant differences between IVF twins and singletons disappeared.
- Neurological outcomes and blood pressure were similar between the groups.
Conclusions:
- The initial observed developmental disadvantages in IVF twins are not unique to the IVF process.
- These findings suggest that the general adverse effects associated with twin gestation persist in the context of IVF.
- IVF treatment itself does not appear to exacerbate or mitigate the developmental differences typically seen between twins and singletons.
Abstract:
This prospective cohort study evaluated whether the cognitive development, neurological condition, anthropometrics and blood pressure of 4-year-old IVF twins differed from those of 4-year-old IVF singletons; 103 IVF singletons and 48 IVF twins born after conventional IVF treatment were included. Primary outcome was total intelligence quotient (IQ). Secondary outcomes were minor neurological dysfunction, anthropometrics and blood pressure. Unadjusted analyses found that the total IQ score of twins was lower than that of singletons, with a mean difference of -5.4 (-9.7 to -1.0). Weight (singletons: 18.6 [18.1 to 19.1] kg; twins: 16.9 [16.0 to 17.9] kg) and height (singletons: 108.8 [107.9 to 109.8] cm; twins: 105.9 [104.0 to 107.7] cm) of twins were lower than those of singletons (mean values [95% CI]). All differences disappeared after adjusting for mediators and confounders. Neurological outcome, systolic and diastolic blood pressure of twins and singletons were similar. Four-year-old IVF twins had a lower total IQ (-5.4 points), lowerbodyweight (-1.7 kg) and were shorter (-2.9 cm) than 4-year-old IVF singletons. After adjustment, the adverse twin effect disappeared, implying that increased risk for impaired health and development in twins also holds true for IVF twins, and is not altered by IVF.