The eff ect of multiple gestation on perinatal outcomes in assisted reproductive technology pregnancy

I n t r o d u c t i o n . In assisted reproductive technology pregnancy (ARTP), the most unfavorable factor aff ecting perinatal outcomes is iatrogenic multiple gestation. Active introduction into practice of techniques that reduce the risk of multiple pregnancy, on the one hand, and management of ARTP in specialized medical centers with experience in working with this category of patients, on the other, can improve perinatal outcomes.
A i m . Analysis of perinatal outcomes in assisted singleton and multiple pregnancies in order to assess the contribution of the multiple gestation factor to adverse health outcomes for newborns, and its relevance for improving of assisted reproductive technology.
M a t e r i a l s  a n d  m e t h o d s . A retrospective study of the ante-, intra- and early neonatal period was carried out in 672 infants born at the Medical Center AVICENNA (Novosibirsk) for the period from 2006 to 2015. The total sample was divided into 3 groups: 1st – infants from singleton ARTP (n = 345); 2nd – infants from multiple ARTP (n = 177); 3rd – infants from singleton spontaneous pregnancy (SSP) (n = 150) without infertility in the parental history, gravidity and parity were equal. A clinical and anamnestic method was used, with an assessment of the main parameters of the health status of infants and parents.
R e s u l t s . It was revealed that complications such as threatened miscarriage and preterm labor, cervical insuffi  ciency, preeclampsia, and placental disorders are diagnosed signifi cantly more often in multiple ARTP (p < 0.001) compared with singleton ARTP. At the same time, in the setting of a specialized center, the majority of infants from ARTP were full-term, both in singleton (94.5% of cases) and in multiple (52.5% of cases) pregnancies. Any assisted reproductive technology pregnancy belongs to the group of high obstetric risk, but timely correction of complications signifi cantly improves perinatal outcomes.
C o n c l u s i o n . ARTP belongs to the group of high obstetric risk, which increases signifi cantly with multiple gestation. Management of an infertile couple in a specialized center with continuity at all stages from the moment of contacting the clinic to the birth of a child allows, despite the development of complications, to ensure the birth of full-term infants (both in singleton and multiple pregnancies), and in singleton pregnancies it leads to the birth of children, in main health indicators similar to those from a spontaneous pregnancy.

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