Preterm birth in multiple pregnancies in surrogate mothers

Objective. To compare the rate and pattern of preterm birth in multiple pregnancies in patients after IVF with donor oocytes in the surrogacy program and in patients after IVF with own oocytes. Patients and methods. The analysis of preterm birth in 172 women with dichorionic diamniotic twins who gave birth between 2015 and 2023 was performed. In 99 women, pregnancy occurred in the surrogacy program (IVF-S) and in other 73 women – after IVF with own oocytes (IVF-OO). Only those women who had labor were included in the study. Results. There was no significant increase in the overall rate of preterm birth in patient groups. However, the rate of preterm birth among patients who repeatedly participated in the surrogacy program was significantly higher than in the group of women who participated in the program for the first time (78.9% and 56.2%, respectively; p < 0.05). Spontaneous preterm birth at all gestational ages was prevalent in the IVF-OO group, but the IVF-S group had a high rate of induced preterm birth up to 34 weeks’ gestation (18.3% vs. 7.6%; p < 0.05). Conclusion. Pregnancy after IVF poses a high risk for obstetric complications. Patients entering the surrogacy program should be informed about the increased risk of preterm birth, pre-eclampsia and gestational arterial hypertension. Multiple pregnancies are an additional risk factor for preterm birth in IVF pregnancy. Therefore, the prevention of preterm birth should be aimed at preventing multiple pregnancies following IVF.