Infertility and IVF Unit, Hadassah Ein-Kerem Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
Department of Obstetrics and Gynecology, Hadassah Ein-Kerem Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
BMC Pregnancy Childbirth. 2022 Feb 28;22(1):164. doi: 10.1186/s12884-022-04502-8.
Women undergoing in-vitro fertilization (IVF) treatments are at increased risk for maternal and neonatal complications compared to women who conceive spontaneously. Though spontaneous pregnancies of young women and adolescents have an increased risk for adverse maternal and neonatal outcomes, pregnancy outcomes of this age group, following IVF treatment have been scarcely reported. The aim of this study was to report maternal and neonatal outcomes of young women who conceived following IVF compared to women in the same age group with spontaneous conception.
We performed a multicenter case-control study. The study group included women aged 17-25 years who conceived by IVF with an ongoing singleton pregnancy. For the purpose of the study, a control group matched (1:2 ratio) for maternal age at delivery and parity was constructed. Demographic, medical history, pregnancy related characteristics and maternal and neonatal outcomes were compared between groups. Finally, factors associated with spontaneous vaginal delivery were assessed for the entire cohort using a univariate and multivariate logistic regression model.
Between 2005 and 2021, we identified 80 women aged 19-25 years who conceived by IVF. A control group of 160 women was matched to the study group by age and parity. The unmatched maternal characteristics and pregnancy associated complications were similar among the groups. However, the IVF group had a significantly higher rate of induction of labor (48.1% vs. 26.6%, p = 0.001), meconium-stained amniotic fluid (27.6% vs. 14.1%, p = 0.025), prolonged second stage of labor (26.0% vs. 7.3%, p = 0.001) and operative vaginal delivery (22.5% vs.12.5%, p = 0.048). Neonatal outcomes were for the most part comparable; nevertheless, we found a higher rate of neonates with an umbilical artery pH < 7.1 in the IVF group (9.8% vs. 0.0%, respectively; p = 0.022). A logistic regression analysis for spontaneous vaginal delivery (vs. cesarean or operative vaginal deliveries) found that spontaneous onset of labor (vs. induction of labor) (OR = 2.08; 95% CI = 1.07-4.05, p = 0.03) was positively associated with spontaneous vaginal delivery while prolonged second stage of labor (OR = 0.35; 95% CI = 0.13-0.95, p = 0.04) was negatively associated with this parameter.
Young women who conceive by in-vitro fertilization are expected to reach favorable pregnancy outcomes, comparable to women who conceived spontaneously.
与自然受孕的女性相比，接受体外受精（IVF）治疗的女性发生母婴并发症的风险更高。尽管年轻女性和青少年的自然妊娠有不良母婴结局的风险增加，但很少有报道 IVF 治疗后这一年龄组的妊娠结局。本研究旨在报告与自然受孕的同年龄组女性相比，通过 IVF 受孕的年轻女性的母婴结局。
我们进行了一项多中心病例对照研究。研究组包括年龄在 17-25 岁之间通过 IVF 妊娠且持续单胎妊娠的女性。为了研究目的，根据分娩时的母亲年龄和产次，为对照组匹配了 1:2 的比例。比较两组间的人口统计学、病史、妊娠相关特征以及母婴结局。最后，使用单变量和多变量逻辑回归模型评估整个队列中与自然阴道分娩相关的因素。
2005 年至 2021 年期间，我们共确定了 80 名年龄在 19-25 岁之间通过 IVF 受孕的女性。为研究组匹配了 160 名年龄和产次相匹配的对照组女性。两组间未匹配的母体特征和妊娠相关并发症相似。然而，IVF 组的引产率（48.1% vs. 26.6%，p=0.001）、胎粪污染羊水（27.6% vs. 14.1%，p=0.025）、第二产程延长（26.0% vs. 7.3%，p=0.001）和经阴道分娩（22.5% vs. 12.5%，p=0.048）的发生率显著更高。新生儿结局在大多数方面相当；然而，我们发现 IVF 组新生儿脐动脉 pH 值<7.1 的发生率更高（9.8% vs. 0.0%，p=0.022）。对自然阴道分娩（vs. 剖宫产或经阴道分娩）的逻辑回归分析发现，与引产相比，自然发动的产程（OR=2.08；95%CI=1.07-4.05，p=0.03）与自然阴道分娩呈正相关，而第二产程延长（OR=0.35；95%CI=0.13-0.95，p=0.04）与该参数呈负相关。
通过体外受精受孕的年轻女性有望获得与自然受孕女性相当的良好妊娠结局。
