Department of Gynecology and Obstetrics, Technische Universität Dresden, Germany, Fetscher Straße 74, 01307 Dresden, Germany.
Department of Gynecology and Obstetrics, Technische Universität Dresden, Germany, Fetscher Straße 74, 01307 Dresden, Germany.
Eur J Obstet Gynecol Reprod Biol. 2021 Sep;264:76-82. doi: 10.1016/j.ejogrb.2021.06.047. Epub 2021 Jul 4.
Pregnancies and births following assisted reproductive treatment (ART) are related to an increased risk for adverse perinatal outcomes. The aim of this retrospective cohort study at a University Hospital with a tertiary perinatal center was the combined risk analysis of singleton and twin pregnancies after ART in comparison to spontaneously conceived pregnancies.
Maternal and fetal risks were analyzed in subgroups after spontaneous conception (N = 14,233) and ART (N = 785) during the 6-year study period from 2014 to 2019. Odds ratios for perinatal risks between the groups were calculated and adjusted for maternal age and gestational week at birth using a matched control analysis. Subgroups of preterm delivery were compared.
The overall maternofetal risks after ART are higher than after spontaneous conception. Maternal risks after ART are mainly related to higher maternal age (p < 0.001). Preterm delivery and neonatal complications are more frequent in twins than in singletons (p < 0.001), but no statistically significant differences were seen in comparison in the subgroup of twins due to conception. Higher maternal age and body mass index did not increase the risk of preterm birth in twin pregnancies.
Maternal risks in pregnancies after ART are mainly influenced by maternal age. The strongest risk factor in ART pregnancies is a multiple pregnancy. Every 5th pregnancy after ART was a twin pregnancy with higher risks for preterm delivery, maternal hospitalization and adverse neonatal outcome (p < 0.001). Advanced maternal age in ART cannot be altered, but twin pregnancies can be actively avoided using the single embryo transfer strategy.
辅助生殖治疗（ART）后的妊娠和分娩与围产期不良结局的风险增加有关。本研究在一家设有三级围产中心的大学医院进行，旨在对 ART 后单胎和双胎妊娠与自然受孕妊娠进行联合风险分析。
在 2014 年至 2019 年的 6 年研究期间，对自然受孕（N=14233）和 ART（N=785）的孕妇和胎儿风险进行了亚组分析。通过匹配对照分析，计算了两组之间围产期风险的优势比，并根据母亲年龄和分娩时的孕周进行了调整。比较了早产亚组。
ART 后母婴整体风险高于自然受孕。ART 后母体风险主要与母亲年龄较大有关（p<0.001）。与单胎妊娠相比，双胎妊娠的早产和新生儿并发症更为常见（p<0.001），但由于受孕方式不同，在双胎妊娠亚组中没有统计学差异。母亲年龄和体重指数较高不会增加双胎妊娠早产的风险。
ART 后妊娠的母体风险主要受母亲年龄的影响。ART 妊娠的最强风险因素是多胎妊娠。每 5 例 ART 后妊娠中就有 1 例是双胎妊娠，早产、母亲住院和不良新生儿结局的风险更高（p<0.001）。ART 中产妇年龄无法改变，但可以通过单胚胎移植策略积极避免双胎妊娠。
