Department of Obstetrics and Gynecology, Institute for Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; Nordic IVF Center Göteborg, Gothenburg, Sweden.
Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway; Central Norway Regional Health Authority, Stjørdal, Norway.
Fertil Steril. 2016 Oct;106(5):1142-1149.e14. doi: 10.1016/j.fertnstert.2016.06.021. Epub 2016 Jul 9.
To compare the effect of maternal age on assisted reproductive technology (ART) and spontaneous conception (SC) pregnancies regarding maternal and neonatal complications.
Nordic retrospective population-based cohort study. Data from national ART registries were cross-linked with national medical birth registries.
Not applicable.
PATIENT(S): A total of 300,085 singleton deliveries: 39,919 after ART and 260,166 after SC.
INTERVENTION(S): None.
MAIN OUTCOME MEASURE(S): Hypertensive disorders in pregnancy (HDP), placenta previa, cesarean delivery, preterm birth (PTB; <37 weeks), low birth weight (LBW; <2,500 g), small for gestational age (SGA), and perinatal mortality (≥28 weeks). Adjusted odds ratios (AORs) were calculated. Associations between maternal age and outcomes were analyzed.
RESULT(S): The risk of placenta previa (AOR 4.11-6.05), cesarean delivery (AOR 1.18-1.50), PTB (AOR 1.23-2.19), and LBW (AOR 1.44-2.35) was significantly higher in ART than in SC pregnancies for most maternal ages. In both ART and SC pregnancies, the risk of HDP, placenta previa, cesarean delivery, PTB, LBW, and SGA changed significantly with age. The AORs for adverse neonatal outcomes at advanced maternal age (>35 years) showed a greater increase in SC than in ART. The change in risk with age did not differ between ART and SC for maternal outcomes at advanced maternal age.
CONCLUSION(S): Having singleton conceptions after ART results in higher maternal and neonatal outcome risks overall, but the impact of age seems to be more pronounced in couples conceiving spontaneously.
比较辅助生殖技术（ART）和自然受孕（SC）妊娠中母亲和新生儿并发症方面的母亲年龄效应。
北欧回顾性基于人群的队列研究。来自国家 ART 登记处的数据与国家医疗出生登记处交叉链接。
不适用。
共 300,085 例单胎分娩：39,919 例 ART 后分娩，260,166 例 SC 后分娩。
无。
妊娠高血压疾病（HDP）、前置胎盘、剖宫产、早产（PTB；<37 周）、低出生体重（LBW；<2,500g）、小于胎龄儿（SGA）和围产儿死亡率（≥28 周）。计算调整后的优势比（AOR）。分析母亲年龄与结局之间的关系。
对于大多数母亲年龄，ART 妊娠中胎盘前置（AOR 4.11-6.05）、剖宫产（AOR 1.18-1.50）、PTB（AOR 1.23-2.19）和 LBW（AOR 1.44-2.35）的风险明显高于 SC 妊娠。在 ART 和 SC 妊娠中，HDP、胎盘前置、剖宫产、PTB、LBW 和 SGA 的风险随着年龄的增长而显著变化。在 SC 中，高龄（>35 岁）时不良新生儿结局的 AOR 增加幅度大于 ART。高龄时的母体结局的风险变化与 ART 和 SC 之间没有差异。
ART 后单胎妊娠总体上导致更高的母婴结局风险，但在自然受孕的夫妇中，年龄的影响似乎更为明显。
