Perinatal outcome in twins. A hospital based comparative study at a single third-level care centre in Croatia

Abstract

Perinatal outcome in twins. A hospital based comparative study at a single third-level care centre in Croatia Dino Pavoković1, * ,† , Vesna Elveđi Gašparović2,3, * ,† , Tvrtko Tupek4 , Analena Gregorić5 , Ana Tikvica Luetić4,6,† , Dubravko Habek4,6 1Department of Obstetrics and Gynaecology, General Hospital Virovitica, 33000 Virovitica, Croatia 2Department of Obstetrics and Gynaecology, University Hospital Centre Zagreb, 10000 Zagreb, Croatia 3 School of Medicine, University of Zagreb, 10000 Zagreb, Croatia 4Department of Obstetrics and Gynaecology, Clinical Hospital 'Sveti Duh', 10000 Zagreb, Croatia 5Department of Obstetrics and Gynaecology, General Hospital Karlovac, 47000 Karlovac, Croatia 6 School of Medicine, Catholic University of Croatia, 10000 Zagreb, Croatia *Correspondence: pavokovic@hotmail.com (Dino Pavoković); vesnagasparo@gmail.com (Vesna Elveđi Gašparović) † These authors contributed equally. DOI:10.31083/j.ceog.2021.03.2450 This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/). Submitted: 4 January 2021 Revised: 22 February 2021 Accepted: 4 March 2021 Published: 15 June 2021 Background: The goal of our study is to explore the association of assisted reproductive technology (ART) as contributing factor for obstetric complications and perinatal outcome in twin pregnancies during a 14-year period at a single tertiary centre. Methods: We collected the data (from maternal and neonatal medical records) from 731 twin pregnancies; 192 conceived by ART and 539 twin pregnancies conceived naturally during a 14-year period. Results: Pregnancy complications in twin pregnancies mainly included preterm premature rupture of membranes, gestational diabetes mellitus, and preeclampsia. Higher occurrence of placenta praevia in the ART group was the only perinatal risk related to twin pregnancies in the ART group as compared to those conceived naturally. Over 71% of ART twins were delivered by caesarean section, which is considerably increased as compared to non-ART twins (P = 0.042). Neonatal complications in both groups mainly included low Apgar score in the 1st minute, low birth weight and admission to NICU, and the incidences of these complications were comparable between the groups. Conclusion: Our results indicated that ART procedures were not followed by adverse obstetric and perinatal outcome in twin pregnancy delivered at single tertiary centre, except for the slightly higher risk of placenta praevia. Keywords Twin pregnancy; Assisted reproductive technology; Obstetric complications