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Effect of Parity on Preterm Delivery in Twin Gestations Conceived with IVF

  • Michael S. Awadalla
    Correspondence
    Corresponding author: Present address: Dr. Michael Awadalla, Institute for Reproductive Health, 3805 Edwards Rd Suite 450, Cincinnati, OH 45209, , cell phone for Michael Awadalla: (859) 468-7698
    Affiliations
    Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, California
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  • Wael H. Salem
    Affiliations
    Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, California
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  • Jacqueline R. Ho
    Affiliations
    Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, California
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  • Victoria K. Cortessis
    Affiliations
    Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, California

    Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California
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  • Ali Ahmady
    Affiliations
    Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, California
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  • Richard J. Paulson
    Affiliations
    Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, California
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Open AccessPublished:January 20, 2023DOI:https://doi.org/10.1016/j.xfre.2023.01.005
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      Objective

      To determine the relationship between prior obstetrical history and gestational age at delivery in a twin pregnancy.

      Design

      Retrospective cohort study.

      Setting

      This is a United States SART CORS database study.

      Patients

      Patients undergoing IVF in the United States with live delivery of twins.

      Interventions

      None.

      Main outcome measures

      The main outcome measures are median gestational age at delivery and rate of preterm delivery (before 37 weeks).

      Results

      The median gestational age at delivery of IVF-conceived twins was 36.3 [IQR 34.4, 37.6] weeks for nulliparous women, 35.9 [34.0, 37.1] weeks for parous women with a prior preterm birth, and 36.7 [35.1, 37.7] weeks for parous women without a prior preterm birth (p < 0.01 for all comparisons). The rate of preterm delivery was 61% for nulliparous women, 70% for parous women with a prior preterm birth, and 55% for parous women without a prior preterm birth (p value < 0.01 for all comparisons).

      Conclusions

      Parous women without a history of preterm delivery had lower rates of preterm delivery in a subsequent twin pregnancy compared to nulliparous women. Nulliparous women had lower rates of preterm delivery compared to parous women with a history of a preterm delivery.

      Key Words