The clinical characteristics differences between IVF twins and naturally conceived twins with preterm infants

With the rapid development of Assisted Reproductive Technology, in vitro fertilization (IVF) has become one of the most important treatments for infertility. However, the widespread use of IVF has significantly increased the incidence of twin pregnancies, which in turn raises the risk of preterm twin births. Twin pregnancies are inherently high-risk, often associated with complications such as preterm labor, fetal growth restriction, and congenital malformations, all of which can severely impact the health of both mothers and infants. The aim of this study is to investigate the differences between IVF twin preterm infants and naturally conceived twin preterm infants. In this study, we included 144 cases of twin preterm infants born in the obstetrics department of our hospital and subsequently transferred to the neonatal unit between January 2021 and June 2024. Using a retrospective cohort design, we divided the cases into 2 groups: 72 IVF-embryo transfer cases (observation group) and 72 naturally conceived cases (control group). We compared the 2 groups in terms of general characteristics, mode of delivery, premature rupture of membranes, congenital heart disease, intracranial hemorrhage, neonatal conditions, and hospitalization to assess the impact of IVF on twin preterm infants and maternal perinatal diseases. The results showed that the observation group had a significantly higher proportion of assisted perineal lateral incisions, a higher incidence and longer duration of premature rupture of membranes (P < .05), and a higher incidence of atrial septal defect (P < .05) compared to the control group. Additionally, the incidence of neonatal hyperbilirubinemia, intracranial hypertension syndrome, and hypocalcemia was significantly higher in the observation group (P < .05), whereas the incidence of twin-twin transfusion syndrome was significantly lower (P < .05). During hospitalization, the observation group required enteral and intravenous nutrition for a significantly longer period than the control group (P < .05). Regarding maternal characteristics, the observation group had a higher maternal age, a greater proportion of primigravida, and significantly higher rates of hypothyroidism during pregnancy and antenatal antibiotic use compared to the control group (P < .05). In conclusion, IVF twin preterm infants exhibited significant differences in clinical characteristics and maternal perinatal disorders when compared to naturally conceived twin preterm infants. This suggests that IVF technology may present additional clinical management challenges while enabling twin pregnancies.