Does assisted reproductive technology increase adverse perinatal outcome in preterm twins ? A hospital based comparative study at a single tertiary center in Croatia

Objective: The aim of this study is to investigate the association of assisted reproductive technology (ART) as an independent risk factor for obstetric complications and perinatal outcome in preterm twin pregnancies in 5 years period at a single tertiary center. Methods: We collected the data (from maternal and neonatal medical records) from 88 preterm twin pregnancies conceived after ART and 147 preterm twin pregnancies conceived naturally in a 5-year period. Results: Pregnancy complications in ART mainly included preterm premature rupture of membranes, gestational hypertension and gestational diabetes. More than 85% of ART twins were born by caesarean section, significantly higher than non-ART twins (p = 0.005). Neonatal complications in both groups mainly included low Apgar score in 1st minute, perinatal infections, respiratory distress syndrome (RDS) and hyperbilirubinemia and the incidences of these complications were comparable between the groups. According to Weinberg’s differential rule, there were 32 monozygotic ART twins and 119 monozygotic non-ART twins. This represents a monozygotic twin rate of 4.7% for ART births and 0.6% for non-ART births. Conclusion: Our results indicated that ART procedures were not associated with adverse perinatal outcome and that ART is not associated with increased obstetric complications in preterm twins followed and born in a single tertiary center