Background Studies comparing perinatal outcomes in multiples conceived following the use of artificial reproductive technologies (ART) vs. spontaneous conception (SC) have reported conflicting results in terms of mortality and morbidity. The objective of our study was to compare perinatal and neonatal outcomes of multiplets born after artificial reproductive technology (ART) and spontaneous conception (SC).

Methods Three hundred and sixty seven neonates born after SC and 596 after ART were studied. Maternal characteristics, neonatal characteristics, neonatal morbidities and mortality were assessed between two groups.

Results The duration of pregnancy was significantly shorter in ART group (32.6±4.0 vs 34.2±3.2, p<0.001). The mean birth weight in the ART group was significantly lower when compared with control group (1892±690 vs 2112±602, p<0.001). The number of perinatal and neonatal deaths (9.5 vs 2.7%, p<0.001 and 1.7 vs 1%, p<0.001) were significantly higher in the ART group. The incidence of intraventricular hemorrhage (63.7 vs 52.8%, p<0.05), anemia (26.6 vs 16.5%, p<0.05), sepsis (22.3 vs 14.6%, p<0.05), bronchopulmonary displasia (7.1 vs 1.8%, p<0.05), retinopathy of prematurity (24 vs 16.1 %, p<0.05) were significantly higher in the study group.

Conclusion Multiple pregnancies achieved with ART are at greater risk for obstetric complications and adverse neonatal outcome in comparison with naturally conceived multiple pregnancies.