Obstetrics and Gynecology Hospital of Fudan University, 352#, Dalin Road, Shanghai, 200011, China.
Shanghai JiAi Genetics & IVF Institute, Shanghai, 200011, China.
BMC Pregnancy Childbirth. 2022 Jun 28;22(1):526. doi: 10.1186/s12884-022-04846-1.
To evaluate the differences in pregnancy outcomes between assisted reproductive technology (ART) patients and natural pregnant women in Shanghai, China in the past 6 years objectively. And to assess the feasibility of the research method of registry-database linkage in mainland China.
This retrospective study was conducted using registry-database linkage. A total of 8102 pregnancies with ART and 8096 parturients with spontaneous conception (SC) from 10 reproductive centers and 111 hospitals composed our retrospective study. The primary outcomes were the rates of obstetric complications (pregnancy-induced hypertention [PIH], gestational diabetes mellitus [GDM], placenta previa, mode of delivery, preterm birth [PTB], low birth weight [LBW], and macrosomia). The prenatal outcomes were compared between ART and SC parturients, frozen-thawed embryo transfer (FET) and fresh embryo transfer, and in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). We calculated odds ratios (ORs) and 95% confidence intervals (CIs).
The final matching rate of the target population was 92% by using registry linkage. ART resulted in a higher rate of multiple birth, PTB, LBW, cesarean section, placenta previa and GDM compared with SC in the singleton cohort. In ART patients, pregnant women with FET had a significantly higher risk of PIH than those with fresh embryo transfer (14.1% Vs 9.3%, AOR1.528, 95% CI 1.303-1.793), but there was no difference between IVF and ICSI. FET is also related to the severity of PIH.
ART increased the rate of complications during pregnancy, the risk and severity of PIH in patients with FET was higher than that in patients with fresh embryo transfer. The registry-database linkage study is an objective and feasible research method in mainland China.
客观评估过去 6 年中国上海接受辅助生殖技术（ART）和自然受孕孕妇妊娠结局的差异，并评估在中国大陆开展注册数据库关联研究方法的可行性。
本回顾性研究采用注册数据库关联。共有 10 个生殖中心和 111 家医院的 8102 例 ART 妊娠和 8096 例自然受孕（SC）产妇纳入本研究。主要结局为产科并发症（妊娠高血压、妊娠期糖尿病、前置胎盘、分娩方式、早产、低出生体重、巨大儿）发生率。比较了 ART 和 SC 产妇、冻融胚胎移植（FET）和新鲜胚胎移植、体外受精（IVF）和卵胞浆内单精子注射（ICSI）的产前结局。计算了比值比（ORs）和 95%置信区间（CIs）。
通过注册链接，目标人群的最终匹配率为 92%。与 SC 相比，在单胎队列中，ART 导致多胎、早产、低出生体重、剖宫产、前置胎盘和妊娠期糖尿病的发生率更高。在 ART 患者中，FET 孕妇的妊娠高血压发生率明显高于新鲜胚胎移植组（14.1%比 9.3%，OR1.528，95%CI1.303-1.793），但 IVF 和 ICSI 之间无差异。FET 也与妊娠高血压的严重程度有关。
ART 增加了妊娠期间并发症的发生率，FET 患者的妊娠高血压风险和严重程度高于新鲜胚胎移植组。注册数据库关联研究是中国大陆一种客观可行的研究方法。
