Maternal characteristics and twin gestation outcomes over 10 years: Impact of conception methods

Twin gestations after fertility treatments are associated significantly with older age, higher prematurity rate, cesarean delivery, and more obstetric complications when compared with those conceived spontaneously.


Christian Bamberg, M.D., Christina Fotopoulou, M.D., Ph.D., Philipp Neissner, M.D., Torsten Slowinski, M.D., Joachim W. Dudenhausen, M.D., Ph.D., Hans Proquitte, Ph.D., Christoph Bührer, M.D., Ph.D., Wolfgang Henrich, M.D., Ph.D.

Vol 98, Issue 1 , Pages 95-101.e1



To compare maternal characteristics and obstetric outcomes of spontaneously conceived (SC) and after–fertility treatment (FT) twins.


Retrospective study.


Single tertiary center (university hospital).


All twin pregnancies (n = 1,239) delivered ≥24 weeks of gestation and classified by the mode of conception.



Main Outcome Measure(s):

Maternal age, prematurity, preterm rupture of membranes (PROM), delivery mode, cervical insufficiency, preeclampsia/HELLP (hemolysis, elevated liver enzymes, low platelet count) syndrome, gestational diabetes, and postpartum hemorrhage.


Of 1,239 mothers evaluated, 34.4% received FT. We observed a continuous 3.2-year mean increase in maternal age over time in the FT population. The FT group had statistically significantly higher rates of women ≥35 years of age versus the SC group (37.6% vs. 22.9%). Mean maternal age (32.5 vs. 30.1 years) and the rates of cesarean delivery (72.3% vs. 63.9%), dichorionic twin prematurity (67.7% vs. 59.6%), postpartum hemorrhage (9.9% vs. 6%), PROM (2.3% vs. 0.6%), and cervical insufficiency (17.6% vs. 10%) were statistically significantly higher in the FT group. Preeclampsia/HELLP syndrome and gestational diabetes showed no significantly significant difference.


Mothers of twins after FT were statistically significantly older and had higher rates of prematurity, cesarean delivery, and obstetric morbidity.

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