Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea.
Reprod Fertil Dev. 2022 Nov;34(18):1107-1114. doi: 10.1071/RD22184.
The number of women who achieve pregnancy through assisted reproductive technology (ART), including in vitro fertilisation and embryo transfer (IVF-ET), is increasing worldwide. Placenta-mediated diseases associated with ART, such as gestational hypertension, preeclampsia, disorders of placental implantation, and placental abruption, are also increasing.
To determine the association between placental pathologies and IVF-ET in women with preterm births.
This retrospective cohort study examined archived placenta specimens of women who achieved pregnancy through either spontaneous conception or IVF-ET. In total, 1677 women with singleton pregnancies who gave birth consecutively between 20 and 37weeks of gestation at Seoul National University Bundang Hospital and underwent placental pathologic evaluation between April 2013 and October 2018 were included. Data from all pathologic reports were reviewed.
The IVF-ETgroup had a higher median maternal age and rate of nulliparity than the natural conception group. The incidence rate of obstetric complications, except preterm premature rupture of membranes and placenta previa, was similar in both groups. The IVF-ET group had a higher incidence rate of placental infarction than the natural conception group (26.4% vs 16.4%, P =0.012). Multivariate logistic regression analysis indicated that IVF, hypertensive disorders, and fetal growth restriction were significantly associated with placental infarction.
IVF-ET was independently associated with the risk of placental infarction in women with preterm births.
The use of IVF-ET may cause abnormal placental formation with an increased risk of anatomical and vascular pathology, which are observed in preterm deliveries and may contribute to pregnancy complications.
通过辅助生殖技术（ART）实现妊娠的妇女人数，包括体外受精和胚胎移植（IVF-ET），在全球范围内正在增加。与 ART 相关的胎盘介导疾病，如妊娠高血压、子痫前期、胎盘植入异常和胎盘早剥，也在增加。
确定胎盘病变与通过 IVF-ET 实现早产的妇女之间的关联。
本回顾性队列研究检查了通过自然受孕或 IVF-ET 受孕的妇女的存档胎盘标本。共有 1677 名在首尔国立大学盆唐医院连续分娩的单胎妊娠妇女，年龄在 20 至 37 孕周之间，并在 2013 年 4 月至 2018 年 10 月期间接受了胎盘病理评估，包括在内。审查了所有病理报告的数据。
IVF-ET 组的母亲年龄中位数和初产妇比例高于自然受孕组。两组的产科并发症发生率（除早产胎膜早破和前置胎盘外）相似。IVF-ET 组的胎盘梗死发生率高于自然受孕组（26.4%比 16.4%，P=0.012）。多变量逻辑回归分析表明，IVF、高血压疾病和胎儿生长受限与胎盘梗死显著相关。
IVF-ET 与早产妇女胎盘梗死的风险独立相关。
IVF-ET 的使用可能导致异常的胎盘形成，增加解剖和血管病理学的风险，这些在早产中观察到，并可能导致妊娠并发症。
