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Research Article
Complications among assisted reproductive technique (ART) twin gestations versus spontaneously conceived twin gestations (SC): A retrospective outcome analysis among an Afro-Caribbean population at a university-based hospital in Jamaica
1 Department of Obstetrics and Gynecology, University Hospital of the West Indies, Mona, Kingston, Jamaica, West Indies
2 The Hugh Wynter Fertility Management Unit, University of the West Indies, Mona, Kingston, Jamaica, West Indies
3 Cancer Prevention and Control, Ragin Lab, Fox Chase Cancer Center-Temple Health, Young Pavilion, Philadelphia, Pennsylvania, USA
Address correspondence to:
Tracey C Martinborough
MBBS, DM, FACOG, Department of Obstetrics and Gynecology, Child and Adolescent Health, University of the West Indies (Mona), Kingston, Jamaica,
West Indies
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Article ID: 100013M01GH2024
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How to cite this article
Harrison G, Carroll K, Martinborough TC, Christie L, Harrison S, Wynter S, Rattray C. Complications among assisted reproductive technique (ART) twin gestations versus spontaneously conceived twin gestations (SC): A retrospective outcome analysis among an Afro-Caribbean population at a university-based hospital in Jamaica. Edorium J Matern Child Health 2024;8(2):12–20.ABSTRACT
Aim: The aim of the study is to compare the frequency of maternal and neonatal complications among pregnant women with twin pregnancies conceived spontaneously versus conceived by assisted reproductive technique (ART).
Methods: Univariate and bivariate analyses of maternal characteristics and neonatal outcomes were performed in this retrospective cohort study at a university-based hospital between 2006 and 2016 in Jamaica, a middle-income Caribbean country. Neonatal data were the primary outcomes: APGAR scores, gestational age, birth weight, admission to the neonatal intensive care unit (NICU), and the level of ventilatory support required. Maternal characteristics, comorbidities, and pregnancy complications were other outcomes studied.
Results: There were 157 SC and 27 ART twin gestations. Women conceiving via ART were more likely to be advanced maternal age (p<0.001), have uterine fibroids (p<0.001), previous myomectomy (p=0.001), and incompetent cervix (p=0.003), delivery by cesarean section (p=0.007), and experience hemorrhage (p=0.017) than SC. There were no statistically significant differences in rates of preterm births, birth weight, APGAR scores, or NICU admissions. Assisted reproductive technique twins were more likely to require continuous positive airway pressure (CPAP) (p=0.025), with no differences observed between the two groups for neonatal respiratory distress.
Conclusion: In our predominantly Afro-Caribbean population, ART mothers were observed to have more poor maternal outcomes than mothers who conceived spontaneously. Assisted reproductive technique and SC twins had similar neonatal outcomes; however, ART twins were more likely to require CPAP.
Keywords: ART, Multiple gestation, Spontaneously conceived, Twin
SUPPORTING INFORMATION
Author Contributions
Giselle Harrison - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Kamali Carroll - Substantial contributions to conception and design, Acquisition of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Tracey C Martinborough - Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Loxley Christie - Acquisition of data, Interpretation of data, Drafting the article, Final approval of the version to be published
Sharon Harrison - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Final approval of the version to be published
Shaun Wynter - Substantial contributions to conception and design, Analysis of data, Interpretation of data, Drafting the article, Final approval of the version to be published
Carole Rattray - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2024 Giselle Harrison et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
