Lucie Guilbaud1, Pietro Santulli2, Eva Studer3, Vanessa Gayet4, François Goffinet5, Camille Le Ray5. 1. Maternité Port Royal, Hôpital Cochin, Assistance Publique Hôpitaux de Paris, Paris, France; DHU Risques et Grossesse, Paris, France. Electronic address: lucie.guilbaud@gmail.com. 2. Département de Gynécologie et de Médecine de la Reproduction, Hôpital Cochin, Assistance Publique Hôpitaux de Paris, Paris, France; Université Paris Descartes, Faculté de Médecine Sorbonne Paris Cité, Paris, France. 3. Maternité Port Royal, Hôpital Cochin, Assistance Publique Hôpitaux de Paris, Paris, France; DHU Risques et Grossesse, Paris, France. 4. Département de Gynécologie et de Médecine de la Reproduction, Hôpital Cochin, Assistance Publique Hôpitaux de Paris, Paris, France. 5. Maternité Port Royal, Hôpital Cochin, Assistance Publique Hôpitaux de Paris, Paris, France; Université Paris Descartes, Faculté de Médecine Sorbonne Paris Cité, Paris, France; DHU Risques et Grossesse, Paris, France.
Abstract
OBJECTIVE: To compare perinatal outcomes of twin pregnancies after oocyte donation (OD), in vitro fertilization (IVF) with autologous oocyte (AO), and non-IVF conception. DESIGN: Five-year retrospective cohort study. SETTING: Tertiary university medical center. PATIENT(S): All patients with twin pregnancies who gave birth after 24 weeks of gestation. The outcomes of 102 OD twin pregnancies were compared with those of 201 AO and 369 non-IVF twin pregnancies. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Obstetrical complications (pregnancy-induced hypertensive disorders, gestational diabetes, cholestasis, preterm rupture of membranes, mode of delivery, and postpartum hemorrhage) and neonatal outcome (preterm birth, low birth weight, neonatal hospitalization, and perinatal mortality). RESULT(S): There was an increased incidence of preeclampsia (OD 26.5%, AO 7.0%, non-IVF 8.7%) and postpartum hemorrhage (OD 23.5%, AO 12.4%, non-IVF 7.6%) in the OD group compared with the AO and non-IVF groups. After adjustment for confounding factors, including maternal age and chorionicity, the risk of preeclampsia remained higher in the OD group, as did the risk of postpartum hemorrhage. The OD group was not at higher risk than the AO and non-IVF groups for other complications, particularly for preterm birth or low birth weight. CONCLUSION(S): OD twin pregnancies are associated with a higher risk of preeclampsia and postpartum hemorrhage than AO and non-IVF twin pregnancies.
OBJECTIVE: To compare perinatal outcomes of twin pregnancies after oocyte donation (OD), in vitro fertilization (IVF) with autologous oocyte (AO), and non-IVF conception. DESIGN: Five-year retrospective cohort study. SETTING: Tertiary university medical center. PATIENT(S): All patients with twin pregnancies who gave birth after 24 weeks of gestation. The outcomes of 102 OD twin pregnancies were compared with those of 201 AO and 369 non-IVF twin pregnancies. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Obstetrical complications (pregnancy-induced hypertensive disorders, gestational diabetes, cholestasis, preterm rupture of membranes, mode of delivery, and postpartum hemorrhage) and neonatal outcome (preterm birth, low birth weight, neonatal hospitalization, and perinatal mortality). RESULT(S): There was an increased incidence of preeclampsia (OD 26.5%, AO 7.0%, non-IVF 8.7%) and postpartum hemorrhage (OD 23.5%, AO 12.4%, non-IVF 7.6%) in the OD group compared with the AO and non-IVF groups. After adjustment for confounding factors, including maternal age and chorionicity, the risk of preeclampsia remained higher in the OD group, as did the risk of postpartum hemorrhage. The OD group was not at higher risk than the AO and non-IVF groups for other complications, particularly for preterm birth or low birth weight. CONCLUSION(S): OD twin pregnancies are associated with a higher risk of preeclampsia and postpartum hemorrhage than AO and non-IVF twin pregnancies.