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Neonatal outcome and development of premature twins following assisted reproductive technology

FENG Chunyang;XUE Yujie;LI Dong;Graduate School, Dalian Medical University;Neonatology Department, Dalian Women and Children's Medical Group;  
Objective To analyze the neonatal outcome and long-term development of assisted reproductive technology(ART and natural conception(NC) in premature twins. Methods Premature twins, who were born in Dalian Women and Children's Medical Center from January 2019 to December 2020, admitted to the neonatal intensive care unit(NICU) and regularly followed up after discharge, were included in the study. According to the way of conception, the infants were divided into ART group(168 cases) and NC group(54 cases). The general data of the mother and newborn, including maternal age, gestational hypertension, gestational diabetes, chorioamnionitis, premature rupture of membranes, mode of delivery, fetal sex, Apgar score,and presence of growth differences, were collected. Birth outcome and disease(neonatal asphyxia, respiratory distress syndrome,neonatal necrotizing small bowel colitis, patent ductus arteriosus, and intracranial hemorrhage) during hospitalization were analyzed. Outpatient follows up information including the length, weight, and head circumference data at the corrected age(CA) of 6 months and 12 months were summarized. We analyzed and compared the general conditions, birth comorbidities,and growth and development in infancy between the two groups. Risk factor for respiratory support in admission was also analyzed. Results The maternal age in the ART group [32.15(31.59, 32.17) years] was significantly different from that in the NC group [29.65(28.45, 30.84) years](P0.001). While the incidence of gestational hypertension, gestational diabetes, premature rupture of membranes and chorioamnionitis in the ART group was similar to that in the NC group(P0.05). There were no significant differences in gestational age at birth, gender, mode of birth, Apgar score, presence of growth difference between twins, duration of feeding, and respiratory support in the ART group compared with the NC group(P0.05). The differences in birth comorbidities(neonatal asphyxia, very low birth weight of the infant, neonatal hypoglycemia, respiratory distress syndrome, early onset sepsis, patent ductus arteriosus) were not statistically significant(P0.05). And there were no differences when comparing the physical growth indicators(length, weight, head circumference) during infancy between the ART and NC groups(P0.05). Gestational diabetes mellitus as well as premature rupture of membranes were the risk factors for preterm infants requiring respiratory support after birth(P0.05). Conclusion ART doesn't increase the risk of adverse birth outcome for premature twins. Gestational diabetes mellitus and premature rupture of membranes are the independent risk factors for respiratory support in premature infants.
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