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Poster Session 4

(1115) Fertility treatments resulting in twin pregnancy and the risk for childhood infectious disease

Friday, January 31, 2025
4:00 PM – 6:00 PM  

    Submitting Author and Presenting Author(s)

  • Moran Shahar, MD

    Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
    Beer Sheva, HaDarom, Israel

    • Coauthor(s)

  • Gil Gutvirtz, MD

    Soroka University Medical Center
    Metar, HaDarom, Israel

  • Tamar Wainstock, PhD (she/her/hers)

    Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
    Beer Sheva, HaDarom, Israel

  • Eyal Sheiner, MD, PhD

    Head of department of Obstetrics and Gynecology, Soroka University Medical Center
    Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
    Beer Sheva, HaDarom, Israel

Objective: Recent research suggests that singleton pregnancies achieved using fertility treatment are at an increased risk for long-term infectious morbidity of the offspring as compared with spontaneous singleton pregnancies. Scarce data exists regarding twins. We investigated the risk of long-term infectious morbidity among twins born following fertility treatments.

Study Design: A population-based retrospective cohort study of all twin deliveries born between the years 1991-2021 at a tertiary center. Twins born using fertility treatments including ovulation induction (OI) and in-vitro fertilization (IVF) were compared with twins born following spontaneous pregnancies. The long-term infectious morbidity was compared based on data from community clinics visits and hospitalizations of offspring up to the age of 18 involving an infectious morbidity. The diagnoses of infectious morbidities were based on ICD-9 codes used in the clinics and hospital wards. A Kaplan–Meier survival curve was used to compare the cumulative incidence of infectious morbidities and a Cox proportional hazards model was constructed to control for confounders.

Results:

A total of 7790 twins met the inclusion criteria: 2076 twins (26.6%) were born following fertility treatments, among them 696 (8.9%) were born using OI and 1380 (17.7%) following IVF. The total infectious morbidity rate was significantly higher in twins born following fertility treatments as compared with twins from spontaneous pregnancies (73.3% for OI, 71.1% for IVF and 64.1% for spontaneous twins, p< 0.001). Likewise, the cumulative incidence of infectious morbidity over time was higher for twins born following fertility treatments (Figure). In the Cox regression model, controlling for maternal and gestational age, hypertensive disorders, diabetes mellitus and ethnicity, fertility treatments resulting in twin pregnancy were found to be an independent risk factor for long-term infectious morbidity of the offspring (Table).

Conclusion: In our cohort, twins born following fertility treatments were found to be at higher risk for long-term infectious morbidity.