Romundstad Liv Bente, Romundstad Pål R, Sunde Arne, von Düring Vidar, Skjaerven Rolv, Vatten Lars J
Department of Obstetrics and Gynaecology, St Olavs University Hospital, Torndheim, Norway.
Hum Reprod. 2006 Sep;21(9):2353-8. doi: 10.1093/humrep/del153. Epub 2006 May 25.
The risk of placenta previa may be increased in pregnancies conceived by assisted reproduction technology (ART). Whether the increased risk is due to factors related to the reproductive technology, or associated with maternal factors, is not known.
In a nationwide population-based study, we included 845,384 pregnancies reported to the Medical Birth Registry of Norway between 1988 and 2002 and compared the risk of placenta previa in 7568 pregnancies conceived after assisted fertilization, with the risk in naturally conceived pregnancies. To study the influence of ART more directly, we compared the risk of placenta previa between consecutive pregnancies among 1349 women who had conceived both naturally and after assisted fertilization. Odds ratios (OR), adjusted for maternal age, parity, previous Caesarean section and time interval between pregnancies were estimated using logistic regression.
There was a six-fold higher risk of placenta previa in singleton pregnancies conceived by assisted fertilization compared with naturally conceived pregnancies [adjusted OR 5.6, 95% confidence interval (CI) 4.4-7.0]. Among mothers who had conceived both naturally and after assisted fertilization, the risk of placenta previa was nearly three-fold higher in the pregnancy following assisted fertilization (adjusted OR 2.9, 95% CI 1.4-6.1), compared with that in the naturally conceived pregnancy.
The use of ART is associated with an increased risk of placenta previa. Our findings suggest that the increased risk may be caused by factors related to the reproductive technology.
辅助生殖技术（ART）受孕的妊娠中，前置胎盘的风险可能会增加。尚不清楚这种风险增加是由于生殖技术相关因素，还是与母体因素有关。
在一项基于全国人口的研究中，我们纳入了1988年至2002年间向挪威医疗出生登记处报告的845384例妊娠，并比较了7568例辅助受精后受孕的妊娠中前置胎盘的风险与自然受孕妊娠的风险。为了更直接地研究ART的影响，我们比较了1349名自然受孕和辅助受精后受孕的女性连续妊娠之间前置胎盘的风险。使用逻辑回归估计调整了产妇年龄、产次、既往剖宫产史和妊娠间隔时间后的优势比（OR）。
与自然受孕妊娠相比，辅助受精单胎妊娠中前置胎盘的风险高6倍[调整后的OR为5.6，95%置信区间（CI）为4.4-7.0]。在自然受孕和辅助受精后均受孕的母亲中，与自然受孕妊娠相比，辅助受精后妊娠中前置胎盘的风险高出近3倍（调整后的OR为2.9，95%CI为1.4-6.1）。
ART的使用与前置胎盘风险增加有关。我们的研究结果表明，风险增加可能是由生殖技术相关因素引起的。
