Neonatal outcomes among twins following assisted reproductive technology: An Australian population-based retrospective cohort study

Wang, AY; Safi, N; Ali, F; Lui, K; Li, Z; Umstad, MP; Sullivan, EA

Neonatal outcomes among twins following assisted reproductive technology: An Australian population-based retrospective cohort study

Wang, AY

Safi, N

Ali, F Lui, K Li, Z

Umstad, MP Sullivan, EA

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Publication Type:: Journal Article
Citation:: BMC Pregnancy and Childbirth, 2018, 18 (1)
Issue Date:: 2018-08-08

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Field	Value	Language
dc.contributor.author	Wang, AY https://orcid.org/0000-0002-3656-4284	en_US
dc.contributor.author	Safi, N https://orcid.org/0000-0001-8473-0980	en_US
dc.contributor.author	Ali, F	en_US
dc.contributor.author	Lui, K	en_US
dc.contributor.author	Li, Z https://orcid.org/0000-0002-7622-150X	en_US
dc.contributor.author	Umstad, MP	en_US
dc.contributor.author	Sullivan, EA https://orcid.org/0000-0002-8718-2753	en_US
dc.date.available	2018-07-26	en_US
dc.date.issued	2018-08-08	en_US
dc.identifier.citation	BMC Pregnancy and Childbirth, 2018, 18 (1)	en_US
dc.identifier.uri	http://hdl.handle.net/10453/129333
dc.description.abstract	© 2018 The Author(s). Background: While their incidence is on the rise, twin pregnancies are associated with risks to the mothers and their babies. This study aims to investigate the likelihood of adverse neonatal outcomes of twins following assisted reproductive technology (ART) compared to non-ART twins. Methods: A retrospective population study using the Australian National Perinatal Data Collections (NPDC) which included 19,662 twins of ≥20weeks gestational age or≥400g birthweight in Australia. Maternal outcomes and neonatal outcomes (preterm birth, low birth weight, resuscitation and neonatal death) were compared. Generalized Estimating Equations were used to assess the likelihood of any neonatal outcomes, with adjusted odds ratio (AOR) and 95% confidence intervals (CI) presented. Weinberg's differential rule was used to estimate monozygotic twin rate. Results: ART mothers were 3.3years older than non-ART mothers. The rates of pregnancy-induced hypertension and gestational diabetes were significantly higher for ART mothers than non-ART mothers (12.2% vs. 8.4%, p< 0.01) and (9.7% vs. 7.5%, p< 0.01) respectively. The incidence of monozygotic twins was 2.0% for ART twins and 1.1% for non-ART twins. Compared with non-ART twins, ART twins had higher rates of preterm birth (AOR 1.13, 95% CI: 1.05-1.22), low birth weight (AOR 1.13, 95% CI: 1.05-1.22), and resuscitation (AOR 1.26, 95% CI: 1.17-1.36). Liveborn ART twins had 28% (AOR 1.28, 95% CI 1.09-1.50) increased odds of having any adverse neonatal outcome compared to liveborn non-ART twins, especially for opposite-sex ART twins (AOR 1.42, 95% CI 1.11-1.82). Conclusion: As ART twins had higher rates of adverse outcome, special prenatal care is recommended. Couples accessing ART should be fully informed of the risk of adverse outcome of twin pregnancies.	en_US
dc.relation.ispartof	BMC Pregnancy and Childbirth	en_US
dc.relation.isbasedon	10.1186/s12884-018-1949-0	en_US
dc.subject.classification	Obstetrics & Reproductive Medicine	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Diabetes, Gestational	en_US
dc.subject.mesh	Hypertension, Pregnancy-Induced	en_US
dc.subject.mesh	Premature Birth	en_US
dc.subject.mesh	Resuscitation	en_US
dc.subject.mesh	Length of Stay	en_US
dc.subject.mesh	Reproductive Techniques, Assisted	en_US
dc.subject.mesh	Odds Ratio	en_US
dc.subject.mesh	Retrospective Studies	en_US
dc.subject.mesh	Cohort Studies	en_US
dc.subject.mesh	Maternal Age	en_US
dc.subject.mesh	Sex Factors	en_US
dc.subject.mesh	Pregnancy	en_US
dc.subject.mesh	Twins	en_US
dc.subject.mesh	Twins, Dizygotic	en_US
dc.subject.mesh	Twins, Monozygotic	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Infant, Newborn	en_US
dc.subject.mesh	Infant, Low Birth Weight	en_US
dc.subject.mesh	Intensive Care Units, Neonatal	en_US
dc.subject.mesh	Australia	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Pregnancy, Twin	en_US
dc.subject.mesh	Perinatal Death	en_US
dc.title	Neonatal outcomes among twins following assisted reproductive technology: An Australian population-based retrospective cohort study	en_US
dc.type	Journal Article
utslib.citation.volume	1	en_US
utslib.citation.volume	18	en_US
utslib.for	1114 Paediatrics and Reproductive Medicine	en_US
utslib.for	1117 Public Health and Health Services	en_US
utslib.for	1110 Nursing	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Public Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
utslib.copyright.status	open_access
pubs.issue	1	en_US
pubs.publication-status	Published	en_US
pubs.volume	18	en_US

Abstract:

© 2018 The Author(s). Background: While their incidence is on the rise, twin pregnancies are associated with risks to the mothers and their babies. This study aims to investigate the likelihood of adverse neonatal outcomes of twins following assisted reproductive technology (ART) compared to non-ART twins. Methods: A retrospective population study using the Australian National Perinatal Data Collections (NPDC) which included 19,662 twins of ≥20weeks gestational age or≥400g birthweight in Australia. Maternal outcomes and neonatal outcomes (preterm birth, low birth weight, resuscitation and neonatal death) were compared. Generalized Estimating Equations were used to assess the likelihood of any neonatal outcomes, with adjusted odds ratio (AOR) and 95% confidence intervals (CI) presented. Weinberg's differential rule was used to estimate monozygotic twin rate. Results: ART mothers were 3.3years older than non-ART mothers. The rates of pregnancy-induced hypertension and gestational diabetes were significantly higher for ART mothers than non-ART mothers (12.2% vs. 8.4%, p< 0.01) and (9.7% vs. 7.5%, p< 0.01) respectively. The incidence of monozygotic twins was 2.0% for ART twins and 1.1% for non-ART twins. Compared with non-ART twins, ART twins had higher rates of preterm birth (AOR 1.13, 95% CI: 1.05-1.22), low birth weight (AOR 1.13, 95% CI: 1.05-1.22), and resuscitation (AOR 1.26, 95% CI: 1.17-1.36). Liveborn ART twins had 28% (AOR 1.28, 95% CI 1.09-1.50) increased odds of having any adverse neonatal outcome compared to liveborn non-ART twins, especially for opposite-sex ART twins (AOR 1.42, 95% CI 1.11-1.82). Conclusion: As ART twins had higher rates of adverse outcome, special prenatal care is recommended. Couples accessing ART should be fully informed of the risk of adverse outcome of twin pregnancies.

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http://hdl.handle.net/10453/129333