title: Maternal characteristics and twin gestation outcomes over 10 years: impact of conception methods.
abstract: OBJECTIVE
  To compare maternal characteristics and obstetric outcomes of spontaneously conceived (SC) and after-fertility treatment (FT) twins.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Single tertiary center (university hospital).
  
  
  METHODS
  All twin pregnancies (n = 1,239) delivered ≥ 24 weeks of gestation and classified by the mode of conception.
  
  
  METHODS
  None.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Mothers of twins after FT were statistically significantly older and had higher rates of prematurity, cesarean delivery, and obstetric morbidity.
authors.affiliation: Department of Obstetrics, Charité University Medical Center, Berlin, Germany. christian.bamberg@charite.de
authors.forename: Christian
authors.initials: C
authors.lastname: Bamberg
authors.forename: Christina
authors.initials: C
authors.lastname: Fotopoulou
authors.forename: Philipp
authors.initials: P
authors.lastname: Neissner
authors.forename: Torsten
authors.initials: T
authors.lastname: Slowinski
authors.forename: Joachim W
authors.initials: JW
authors.lastname: Dudenhausen
authors.forename: Hans
authors.initials: H
authors.lastname: Proquitte
authors.forename: Christoph
authors.initials: C
authors.lastname: Bührer
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Henrich
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005260:Female; D005306:Fertilization / Q000502:physiology*; D005865:Gestational Age; D006801:Humans; D007246:Infertility / Q000453:epidemiology / Q000628:therapy; D008423:Maternal Age; D009035:Mothers / Q000706:statistics & numerical data*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D059285:Pregnancy, Twin / Q000502:physiology / Q000706:statistics & numerical data*; D027724:Reproductive Techniques, Assisted / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult