辅助生殖技术助孕与自然受孕双绒毛膜双胎妊娠结局比较OA

Objective To investigate the differences in pregnancy outcomes between dichorionic diamniotic(DCDA)twin pregnancies conceived via assisted reproductive technology(ART)and those from spontaneous con-ception,in order to provide evidence for the perinatal management of ART-conceived DCDA twins.Methods A retrospective analysis was conducted on the clinical data of 549 DCDA twin parturients.Based on the mode of con-ception,they were divided into ART group(423 cases)and spontaneous conception group(126 cases).The base-line characteristics,pregnancy complications and neonatal outcomes were compared between the two groups.Re-sults Regarding baseline characteristics,the ART group had higher maternal age,number of previous abortions,proportions of primiparas,proportions of advanced maternal age and greater 24-hour postpartum blood loss,but lower parity and proportion of scarred uterus compared to the spontaneous conception group(P<0.05).For preg-nancy complications,the ART group exhibited higher incidences of hypertensive disorders of pregnancy,placental adhesion,postpartum hemorrhage and a higher application rate of uterine artery ascending branch ligation(P<0.05).There were no statistically significant differences in neonatal-related indicators between the two groups.Af-ter adjusting for confounding factors such as age,number of abortions and parities,ART remained an independent risk factor for hypertensive disorders of pregnancy,placental adhesion and postpartum hemorrhage(P<0.05),while it did not increase the risk of adverse neonatal outcomes.Further subgroup analysis by gestational age showed that in the late preterm subgroup,the risk of ART-related pregnancy complications remained elevated(P<0.05).Additionally,neonatal outcomes showed no significant difference between the two groups in both the late preterm and term subgroups.Conclusion ART increases the risk of hypertensive disorders of pregnancy,placen-tal adhesion and postpartum hemorrhage in DCDA twin parturients.Clinically,enhanced monitoring of blood pres-sure during pregnancy and blood loss during delivery and postpartum,along with targeted prevention and manage-ment of these complications,are crucial for improving pregnancy outcomes.