AUTHOR=Wang Minmin , Chai Jingjing 

TITLE=Comparison of outcomes of monochorionic twin pregnancies conceived by assisted reproductive technology vs. spontaneous conceptions: A systematic review and meta-analysis

JOURNAL=Frontiers in Pediatrics

VOLUME=Volume 10 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2022.962190

DOI=10.3389/fped.2022.962190

ISSN=2296-2360

ABSTRACT=<sec><title>Background</title><p>This review aimed to assess if monochorionic twin pregnancies conceived by assisted conception have worse maternal and neonatal outcomes as compared to those conceived naturally.</p></sec><sec><title>Methods</title><p>Datasets of PubMed, ScienceDirect, CENTRAL, Embase, and Google Scholar were searched for studies comparing maternal and neonatal outcomes of monochorionic twin pregnancies conceived by assisted vs. spontaneous methods.</p></sec><sec><title>Results</title><p>Eight studies comparing 337 assisted with 2,711 spontaneously conceived monochorionic twin pregnancies were included. Meta-analysis revealed that the mode of conception of monochorionic twin pregnancies had no impact on the risk of hypertensive disorders of pregnancy (HDP) (OR: 1.36 95% CI, 0.73, 2.54 <italic>I</italic><sup>2</sup> = 9% <italic>p</italic> = 0.03), twin-twin transfusion syndrome (TTTS) (OR: 0.83 95% CI, 0.52, 1.31 <italic>I</italic><sup>2</sup> = 0% <italic>p</italic> = 0.42), and very preterm delivery (OR: 1.18 95% CI, 0.74, 1.88 <italic>I</italic><sup>2</sup> = 41% <italic>p</italic> = 0.49). We noted no statistically significant difference in the mean birth weights (MD: −17.66 95% CI, −157.23, 121.91 <italic>I</italic><sup>2</sup> = 82% <italic>p</italic> = 0.80), risk of intra-uterine death (OR: 0.90 95% CI, 0.51, 1.60 <italic>I</italic><sup>2</sup> = 36% <italic>p</italic> = 0.73) and small for gestational age between the two groups (OR: 0.92 95% CI, 0.67, 1.26 <italic>I</italic><sup>2</sup> = 0% <italic>p</italic> = 0.59). There was an increased risk of caesarean sections (OR: 1.34 95% CI, 1.00, 1.80 <italic>I</italic><sup>2</sup> = 0% <italic>p</italic> = 0.05) and neonatal death with assisted conceptions as compared to spontaneous conceptions (OR: 2.35 95% CI, 1.11, 5.01 <italic>I</italic><sup>2</sup> = 37% <italic>p</italic> = 0.03).</p></sec><sec><title>Conclusion</title><p>Monochorionic twin pregnancies conceived <italic>via</italic> assisted reproductive technology have a heightened risk of cesarean section and neonatal deaths. However, there is a need for further studies to supplement current evidence.</p><p><bold>Systematic Review Registration:</bold><ext-link ext-link-type="uri" xlink:href="https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=325133" xmlns:xlink="http://www.w3.org/1999/xlink">https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=325133</ext-link>, identifier: CRD42022325133.</p></sec>