title: Obstetric and neonatal outcomes of twin pregnancies conceived by assisted reproductive technology compared with twin pregnancies conceived spontaneously: a prospective follow-up study.
abstract: OBJECTIVE
  To compare the obstetric and neonatal outcomes of twin pregnancies conceived by assisted reproduction technology (ART) with spontaneously conceived (SC) twin pregnancies.
  
  
  METHODS
  A prospective cohort study compared all dichorionic twin pregnancies in nulliparous women following fresh in vitro fertilization/intra-cytoplasmic sperm injection (ICSI) or ICSI cycles at Royan Institute (n=320) with SC dichorionic twin pregnancies in nulliparous women at Arash Women's hospital (n=170) from January 2008 to October 2010. These pregnancies were followed-up until hospital discharge following delivery. Obstetric and neonatal outcomes of SC and ART twin pregnancies were compared.
  
  
  RESULTS
  Multivariate analysis, adjusted for maternal age and body mass index, revealed that the obstetric outcomes were similar in both groups. However, the risks of very preterm birth [odds ratio (OR) 5.2, 95% confidence interval (CI) 2.1-12.9], extremely low birth weight (OR 2.2, 95% CI 1.0-3.9), admission to a neonatal intensive care unit (OR 2.0, 95% CI 1.2-3.2) and perinatal mortality (OR 2.3, 95% CI 1.2-4.0) were higher in the ART group.
  
  
  CONCLUSIONS
  The maternal outcomes of ART dichorionic twins were comparable with those of SC twins. However, despite the same obstetric management, the rates of very preterm birth, extremely low birth weight, admission to a neonatal intensive care unit and perinatal mortality were significantly higher in the ART group.
authors.affiliation: Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Centre, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran. a_moini@royaninstitute.org
authors.forename: A
authors.initials: A
authors.lastname: Moini
authors.forename: M
authors.initials: M
authors.lastname: Shiva
authors.forename: A
authors.initials: A
authors.lastname: Arabipoor
authors.forename: R
authors.initials: R
authors.lastname: Hosseini
authors.forename: M
authors.initials: M
authors.lastname: Chehrazi
authors.forename: M
authors.initials: M
authors.lastname: Sadeghi
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects*; D005317:Fetal Growth Retardation / Q000453:epidemiology / Q000209:etiology*; D005500:Follow-Up Studies; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D007492:Iran / Q000453:epidemiology; D015999:Multivariate Analysis; D054238:Perinatal Mortality; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000209:etiology*; D059285:Pregnancy, Twin; D047928:Premature Birth / Q000453:epidemiology / Q000209:etiology*; D011446:Prospective Studies; D012307:Risk Factors; D020554:Sperm Injections, Intracytoplasmic / Q000009:adverse effects