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Perinatal and neonatal outcomes of multiple pregnancies in the middle black sea region: The role of assisted reproductive technology
Emine Genç1, Canan Aygün2, Şükrü Küçüködük21Department of Pediatric Metabolism, University of Health Sciences, Turkey. Istanbul Zeynep Kamil Maternity and Children’s Diseases Health Training and Research Center, Istanbul, Turkey2Department of Neonatology, Ondokuz Mayis University Medicine Faculty, Samsun, Turkey
INTRODUCTION: Due to the increased frequency of multiple pregnancies associated with the growing use of assisted reproductive technologies (ART), babies born from multiple pregnancies continue to attract global attention. Whether conceived through ART or spontaneously, newborns from multiple pregnancies require neonatal intensive care services much more frequently than singletons and have increased morbidity and mortality rates. Furthermore, some researchers argue that ART alone, regardless of the number of fetuses, may contribute to increased morbidity and mortality. In this study, we aimed to determine the morbidity and mortality rates in multiple pregnancies and identify the factors influencing these outcomes.
METHODS: Data on babies born or miscarried from multiple pregnancies between January 2008 and June 2013 at a single university hospital were investigated. Data on the patients and their mothers were collected retrospectively. Data on gestational age, birth weight, ART use, plurality, and sex were evaluated in relation to morbidity and mortality.
RESULTS: A total of 488 babies were born from multiple pregnancies during the study period, and 49.6% of them were conceived through ART. The number of ART-related multiple pregnancies decreased over the years. Of the babies, 60.9% were born between 32 and 37 weeks of gestation, and 53.9% had birth weights between 1500 and 2500 g. Prematurity and its severity were found to be higher in infants born from ART-related multiple pregnancies (p=0.00). Newborns conceived via ART had a significantly lower gestational age at birth (32.59±3.57 vs. 34.17±3.36 weeks) and significantly lower birth weights (1953±672 vs. 2088±621 g).
DISCUSSION AND CONCLUSION: In conclusion, we observed an increased frequency and severity of prematurity among newborns from ART-related multiple pregnancies. Mortality rates demonstrated a declining trend over time, in parallel with the reduced use of ART. These findings, highlighting prematurity as a major risk factor in multiple births, emphasize the critical importance of implementing strategies aimed at preventing multiple pregnancies in ART practices.
Keywords: Assisted reproductive technology, multiple pregnancy, preterm, triplet, twin.
Manuscript Language: English
