Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada.
Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
Eur J Obstet Gynecol Reprod Biol. 2023 Dec;291:106-111. doi: 10.1016/j.ejogrb.2023.10.010. Epub 2023 Oct 18.
To evaluate the odds of developing adverse maternal and perinatal outcomes in primiparous singleton pregnancies conceived with assisted reproductive technology (ART) compared with pregnancies conceived without ART.
A retrospective population-based cohort study using data from the British Columbia Perinatal Data Registry. The population included primiparous women with singleton live or stillbirths delivering at or after 20 weeks' gestation between April 1st 2008-March 31st, 2021. Women who conceived with ART were compared with those who conceived without ART. The main outcome measures were gestational diabetes, hypertensive disorders of pregnancy, preterm birth, low birth weight, neonatal intensive care unit admission, stillbirth, and 5-minute Apgar score. Adjusted odds ratios were calculated.
The study population included 191,059 primiparous women: 183,819 conceived without ART, 7,240 conceived using ART. After controlling for age, body mass index, pre-gestational diabetes, and smoking status, singleton pregnancies conceived by ART had significantly higher odds of gestational diabetes (OR 1.18, 95 % confidence interval [CI] 1.10-1.26) and hypertensive disorders of pregnancy (OR 1.39, 95 % CI 1.29-1.51). There were also significantly increased odds of preterm birth (OR 1.35, 95 % CI 1.25-1.46), low birth weight (OR 1.35, 95 % CI 1.23-1.49), and neonatal intensive care unit admission (OR 1.21, 95 % CI 1.11-1.32). There was not a statistically significant difference in the odds of stillbirth (OR 1.06, 95 % CI 0.72-1.57) or 5-minute Apgar score < 7 (OR 1.10, 95 % CI 0.97-1.26).
There is an increased odds of developing several adverse maternal or neonatal outcomes in primiparous singleton pregnancies conceived by ART including gestational diabetes, hypertensive disorders of pregnancy, preterm birth, low birth weight, and increased incidence of neonatal intensive care unit admissions.
评估辅助生殖技术（ART）受孕的初产妇单胎妊娠与非 ART 受孕的妊娠发生不良母婴围产结局的几率。
这是一项使用不列颠哥伦比亚省围产期数据注册中心数据的回顾性基于人群的队列研究。该人群包括 2008 年 4 月 1 日至 2021 年 3 月 31 日期间在 20 周或以上分娩的活产或死产的初产妇单胎孕妇。将接受 ART 受孕的女性与未接受 ART 受孕的女性进行比较。主要结局指标为妊娠期糖尿病、妊娠高血压疾病、早产、低出生体重、新生儿重症监护病房入院、死产和 5 分钟 Apgar 评分。计算了调整后的优势比。
研究人群包括 191059 名初产妇：183819 名未接受 ART 受孕，7240 名接受 ART 受孕。在控制年龄、体重指数、孕前糖尿病和吸烟状况后，ART 受孕的单胎妊娠发生妊娠期糖尿病（比值比 1.18，95%置信区间[CI]1.10-1.26）和妊娠高血压疾病（比值比 1.39，95%CI1.29-1.51）的几率显著更高。早产（比值比 1.35，95%CI1.25-1.46）、低出生体重（比值比 1.35，95%CI1.23-1.49）和新生儿重症监护病房入院（比值比 1.21，95%CI1.11-1.32）的几率也显著增加。死产（比值比 1.06，95%CI0.72-1.57）或 5 分钟 Apgar 评分<7（比值比 1.10，95%CI0.97-1.26）的几率无统计学差异。
ART 受孕的初产妇单胎妊娠发生多种不良母婴或围产结局的几率增加，包括妊娠期糖尿病、妊娠高血压疾病、早产、低出生体重和新生儿重症监护病房入院率增加。
