Comparison of neonatal outcomes of multiple births for assisted reproductive technology (ART) and non-ART conceptions

The rising multiple birth rate has been attributed to the rising proportion of mothers treated with assisted reproductive technologies (ART). We reviewed the medical records for multiple births at Chung Shan Medical University Hospital (January 1988 to December 2000) to compare the neonatal outcomes of multiple births after the use of ART and without ART. Our data showed that there were higher incidences of prematurity (35.4% vs 10.9%, p<0.05) and low birth weight (39.4% vs 12.3%, p<0.05) in the ART group compared to the control (non-ART) group. The ART group also had higher (p<0.05) prevalences of respiratory distress syndrome (24.1% vs 10.9%), sepsis (10.1% vs 3.4%), retinopathy of prematurity stage III-V (2.6% vs 0.7%), intraventricular hemorrhage grade III-IV (18.4% vs 4.3%) and neonatal asphyxia (3.1% vs 1.0%) than did the control group. But there were no significant differences in the incidences of neonatal mortality and mobidity in four different birthweight categories (below 1000 g, 1000-1499 g, 1500-1999 g and above 2000 g) between the ART and control groups except for the incidence of intraventricular hemorrhage grade III-IV. In conclusion, ART resulted in major increases in multiple births, low birth weight and prematurity. For this reason, the incidence of neonatal mortality and morbidity were higher among multiple-birth infants conceived with ART compared to those conceived without ART.