The first year outcome of twin pregnancies in the Netherlands with a focus on costs; a registry-based study

One of the acknowledged drawbacks of most fertility treatments is the increased risk for twin pregnancies. While survey studies of parents-to-be and twin parents sofar report both groups accept the risk and even may welcome the 2 children given the burdensome treatment, both health outcome and costs of twins represent a substantial disadvantage in medical and economic terms. Current innovation in fertility treatment is focussed on decreasing the risk for twins while keeping the pregnanciy rates about the same. From provisional estimations of the cost-effectiveness of these programmes (like Single Embryo Transfer IVF) as recently published in the ZONMW-report 'Vruchtbaarheidsstoornissen' offered to the Dpt of Health, it appears that the costs of twins, more particular of the twins with adverse outcome (usually very preterm) are a critical factor. Surprisingly, little quantitative information exists on these outcome of twins, where first year clinical costs and medical outcome usually are predictive for life time costs. This study determines first year clinical costs and crude outcome of twins (fertility treatment related vs. not) based on thorough analysis of registry data. Preterms will be compared with similar singleton preterms. The study takes advantage of the current LinKID study under responsibility of 3 medical societies (neonatologists/pediatricians, obstetricians, midwives) which validates the anonymous record of registry data in particular of twins.