Resumen :
OBJETIVO: Establecer el riesgo de complicaciones obstétricas (estados hipertensivos
del embarazo, diabetes gestacional, parto pretérmino, inducción del parto y parto por
cesárea) en las gestaciones gemelares bicoriales en función de si se trata de gestaciones
espontáneas o gestaciones conseguidas m... Ver más
OBJECTIVE: To establish the obstetric risks (hypertensive pregnancy states, gestational
diabetes, preterm delivery, labor induction and cesarean delivery) in dichorionic twin
pregnancies according to whether they are spontaneous or ART pregnancies
MATERIAL AND METHODS: Observational, descriptive, and cross-sectional study
including dichorionic biamniotic twin pregnancies at the Hospital General Universitario
Dr. Balmis (HGUDB) between January 1, 2018, and December 31, 2023. We studied
explanatory variables (age, BMI and the conception method) and other variables such as
obstetric outcomes: Hypertensive disorders of pregnancy (HDP), Gestational Diabetes
(DG), preterm delivery (PP), labor induction, delivery, episiotomy and III and IV tears;
and perinatal outcomes: sex, weight, Apgar test at 5’ and umbilical artery pH. For the
statistical analysis, R software was used. A bivariant analysis was performed between the
variables under study and the conception method. Prevalence Ratio (PR), adjusted PR
(aPR) and their confidence interval at 95% were calculated for obstetric outcomes using
Poisson regression with robust variance.
RESULTS: 208 patients were included in the study; 114 of them (54.81%) had
pregnancies conceived naturally, and 94 (45.19%) had pregnancies conceived through
ART (IVF, Ovodonation-IVF, ISCI-IVF). The average twin pregnancies proportion in
our study was 2.71%, higher than the Spanish average, which is 2.14%. Women in the
assisted reproductive techniques (GG-TRA) group were older [37 vs 34 years p<0.05]
and nulliparous [86.3% vs 54.8% p<0.05] in a larger proportion compared to the spontaneous (GG-E) group. Only episiotomy was significantly higher in the GG-TRA
group [68.9% vs 44.2%, p = 0.023] but after adjustments lost its statistical significance.
No perinatal outcomes differences were found.
CONCLUSIONS: Nearly half of the twin pregnancies in our study were conceived by
Assisted Reproductive Technologies (ART). In the ART group, women were more often
nulliparous and older. No statistically significant differences were found in the obstetric
and perinatal outcomes studied according to the conception method.
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