Twin pregnancies after assisted reproductive technologies: the role of maternal age on pregnancy outcome

Pinzauti, Serena; Ferrata, Chiara; Vannuccini, Silvia; Rienzo, Giulia Di; Severi, Filiberto Maria; Tommaso, Mariarosaria Di

doi:10.1016/j.ejogrb.2016.09.019

Cited by 13 publications

(8 citation statements)

References 31 publications

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“…We found that the relationship of maternal age with the risk of preterm birth in twin pregnancies was different than in singletons and was highest among the lowest maternal age group. While several studies on this topic found no association between maternal age and preterm birth, most of these studies did not focus on women aged less than 20 years 22,26 …”

Section: Discussionmentioning

confidence: 99%

“…The main strengths of our study are its population-based nature and large sample size, which allowed us to stratify maternal age into seven age groups rather than considering it as a dichotomous variable as in many previous studies on this topic. 2,21,22,25,26 Moreover, in contrast to prior studies, 3,21,22,25,26 we included a control group of singleton pregnancies, which allowed us to compare directly the association between AMA and pregnancy outcomes in twins with that observed in singletons. Another important strength is the availability of data on relevant confounding variables such as maternal BMI, maternal income group, race, smoking, and ART.…”

Section: Strengths and Weaknessesmentioning

confidence: 99%

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Maternal age and pregnancy outcomes in twin compared with singleton gestations

Hiersch

Berger

McDonald

et al. 2023

Intl J Gynecology & Obste

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Objective To estimate the association of advanced maternal age with pregnancy complications in twin pregnancies and compare it with that observed in singleton pregnancies. Methods A population‐based retrospective cohort study of all patients with a singleton or twin hospital birth in Ontario, Canada, between 2012 and 2019. The primary outcome was preterm birth (PTB) less than 34 weeks. Pregnancy outcomes were stratified by maternal age groups in twin pregnancies and, separately, in singleton pregnancies. Results A total of 935 378 patients met the study criteria: 920503 (98.4%) had a singleton pregnancy and 14 875 (1.6%) had twins. In singletons, the rate of PTB less than 34 weeks increased progressively with increasing maternal age and was highest for patients aged 45 years or more (3.4%; adjusted risk ratio [aRR] 1.56, 95% confidence interval [CI] 1.05–2.33). By contrast, in twins, although the rate of PTB less than 34 was highest patients under 20 years of age (25.3%) and was lowest among patients aged 35–39 years (11.7%), the associations between maternal age group and the risk of PTB were not statistically significant in the adjusted analysis. Conclusion Although the absolute rates of pregnancy complications are higher in twin pregnancies, there are considerable differences in the relationship between maternal age and the risk of certain complications between twin and singleton pregnancies.

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Section: Discussionmentioning

confidence: 99%

Section: Strengths and Weaknessesmentioning

confidence: 99%

Maternal age and pregnancy outcomes in twin compared with singleton gestations

Hiersch

Berger

McDonald

et al. 2023

Intl J Gynecology & Obste

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“…Okby et al found that in IVF twin pregnancies with preeclampsia, mothers were older and had higher primipara than in twin pregnancies with preeclampsia conceived without ART [ 15 ]. Serena et al found that advanced maternal age (≥40 years) is among the risk factors for twin pregnancies with gestational hypertension/preeclampsia [ 23 ]. Our results are similar to those of these studies.…”

Section: Discussionmentioning

confidence: 99%

The Maternal–Neonatal Outcomes of Twin Pregnancies with Preeclampsia and Their Association with Assisted Reproductive Technology: A Retrospective Study

Lyu

Zhao

et al. 2022

Diagnostics

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Objective: This study aimed to investigate the maternal–neonatal outcomes of twin pregnancies of mothers with preeclampsia and their association with assisted reproductive technology (ART). Methods: A retrospective study on the clinical and maternal–neonatal outcome data of 698 women with twin pregnancies who delivered in our hospital from December 2013 to September 2021 was conducted. Continuous variables were analyzed using a Student’s t-test or Wilcoxon rank-sum test. Categorical variables were analyzed using the Chi-square test. The risk factors of twin pregnancies with preeclampsia were analyzed by logistic regression. Results: The rate of twin pregnancy complicated by preeclampsia was 17.62% (123/698). Logistic regression analysis showed that ART increased the risk of preeclampsia in twin pregnancies (AOR: 1.868, 95% CI: 1.187–2.941). Mothers with preeclampsia carrying twins conceived with ART had a higher rate of delivery at gestational week <34 (29.9% vs. 12.5%) and asphyxia of the neonate at 5 min after delivery (13.4% vs. 1.8%) than those with preeclampsia conceived without ART (p < 0.05). Conclusions: ART increases the risk of preeclampsia in twin pregnancies and the rate of adverse maternal–neonatal outcomes for twin pregnancies with preeclampsia. The policy of single embryo transfer is a method to reduce the adverse pregnancy outcomes of ART.

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“…A report published in 2018 stated that younger women were more likely to become pregnant with predominantly MD twins than older women [ 30 , 31 ]. In our present study, we also found that mothers younger than 25 years had a higher rate of delivering twins with high weight differences and were also more prone to preterm delivery.…”

Section: Discussionmentioning

confidence: 99%

Birth weight reference for Japanese twins and risk factors for infant mortality: A population-based study

Ishida

Takemoto²,

Kato³

et al. 2022

PLoS ONE

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There is no standard birth weight curve for twins in Japan other than a prototype curve based on 1988–1991. Twins have a high perinatal mortality rate than singletons; therefore, we developed a new standard curve for twin birth weight using data from the 1995–2016 Vital Statistics and compared it with previous reports. We used 469,064 cases for analysis, excluding stillbirths and cases with missing values, and created a standard curve using LMS (statistical methods to vary the distribution by using skewness, median, and coefficient of variation) method. In comparison with previous reports, the mean birth weight decreased by 100–200 g. The groups with the lowest neonatal death rates (NDRs) and infant death rates (IDRs) were those with a birth weight of 1,500–2,499 g (NDR: 0.3%, IDR: 0.6%) and those born at 34–36 weeks (NDR: 0.2%, IDR: 0.4%). Compared to these, the IDR was significantly higher in the 2,500–3,999 g group and the 37–39 weeks group (incidence rate ratio (IRR): 1.1 in the 2,500–3,999 g group, IRR: 1.3 in the 37w0d–39w6d group). In particular, the risks of neonatal mortality and infant mortality were higher in infants born at a birth weight above 3,500 g. Infants born at a birth weight above 3,500 g may include recipients of twin-to-twin transfusion syndrome. The most common causes of infant mortality are accidental death and sudden infant death syndrome (SIDS). We considered the possibility that infants treated as healthy newborns and whose mothers were discharged from the hospital without adequate twin care guidance may be more likely to experience unintentional accidents and SIDS at home. The present study suggested that creating a new twin birth weight standard curve and guidance on managing twins at home for full-term and normal birth weight infants may lead to a reduction in infant deaths.

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Twin pregnancies after assisted reproductive technologies: the role of maternal age on pregnancy outcome

Abstract: Our data indicate that nulliparous twin pregnancies conceived with ART in mothers ≥40 years old did not show significantly higher incidence of PB, even if an increased rate of iatrogenic PB <37 weeks is showed.

Cited by 13 publications

References 31 publications

Maternal age and pregnancy outcomes in twin compared with singleton gestations

Maternal age and pregnancy outcomes in twin compared with singleton gestations

The Maternal–Neonatal Outcomes of Twin Pregnancies with Preeclampsia and Their Association with Assisted Reproductive Technology: A Retrospective Study

Birth weight reference for Japanese twins and risk factors for infant mortality: A population-based study

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