Parenting stress in first-time mothers of twins and triplets conceived after in vitro fertilization

Objective: To examine psychosocial and obstetric outcomes at I year postpartum in first-time mothers who conceived after IVF. Design: Prospective cohort study. Setting: University medical center in the United Kingdom. Patient(s): One hundred twenty-nine mothers with a single naturally conceived birth, 95 mothers with a single IVF birth, and 36 mothers with a twin or triplet IVF birth. Main Outcome Measure(s): General Health Questionnaire and Parenting Stress Index. Result(s): Twenty-two percent of mothers of multiples had Parenting Stress Index scores indicating severe parenting stress, compared with 5% of mothers of IVF singletons (odds ratio, 5.14 [95% confidence interval (CI), 1.55-16.991]) and 9% of mothers of naturally conceived singletons (odds ratio, 2.76 [95% Cl, 1.03-7.4]). Mothers of multiple children conceived by IVF did not have poorer mental health but were less likely to be in paid employment at follow-up than were mothers of singletons conceived by lVF (odds ratio, 0.3 [95% CI, 0.13-0.67]) or naturally (odds ratio, 0.27 [95% CI, 0.12-0.59]). Multiple births were more premature, had lower birth weights, and had more medical complications. They were more likely to have been admitted to special care than were singletons conceived by IVF (odds ratio, 14.6 [95% Cl, 5.1-42.0)] or those conceived naturally (odds ratio, 10.59 [95% CI, 3.67-30.57]) Conclusion(s): Clinicians should ensure that couples making decisions about embryo transfer have considered the potential psychosocial burden of a multiple birth.