Department of Social, Behavioral, and Population Sciences, Mary Amelia Center for Women's Health Equity Research, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
Woman's Hospital, Baton Rouge, LA, USA.
J Assist Reprod Genet. 2024 Mar;41(3):613-621. doi: 10.1007/s10815-024-03025-9. Epub 2024 Jan 20.
To examine the impact of medically assisted fertility treatments on the risk of developing perinatal and cardiometabolic complications during pregnancy and in-hospital deliveries.
We conducted a retrospective cohort study using medical health records of deliveries occurring in 2016-2022 at a women's specialty hospital in a southern state of the Unites States (US). Pregnancies achieved using medically assisted reproductive (MAR) techniques were compared with unassisted pregnancies using propensity score matching (PSM), based on demographic, preexisting health, and reproductive factors. Study outcomes included cesarean delivery, gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy (HDP), delivery complications, and postpartum readmission. We used Poisson regression with robust standard errors to generate risk ratios (RRs) and 95% confidence intervals (CIs) for all study outcomes.
Among 57,354 deliveries, 586 (1.02%) pregnancies were achieved using MAR and 56,768 (98.98%) were unassisted ("non-MAR"). Compared to the non-MAR group, MAR pregnancies had significantly higher prevalence of all study outcomes, including GDM (15.9% vs. 11.2%, p < 0.001), HDP (28.2% vs. 21.1%, p < 0.001), cesarean delivery (56.1% vs. 34.6%, p < 0.001), delivery complications (10.9% vs. 6.8%, p = 0.03), and postpartum readmission (4.3% vs. 2.7%, p = 0.02). In a PSM sample of 584 MAR and 1,727 unassisted pregnancies, MAR was associated with an increased risk of cesarean delivery (RR = 1.11, 95% CI = 1.01-1.22); whereas IVF was associated with an increased risk of cesarean delivery (RR = 1.15, 95% CI = 1.03-1.28) and delivery complications (RR = 1.44, 95% CI = 1.04-2.01).
Women who conceived with MAR were at increased risk of cesarean deliveries, and those who conceived with IVF were additionally at risk of delivery complications.
探讨医学辅助生育治疗对妊娠和住院分娩期间围产期和心脏代谢并发症风险的影响。
我们使用美国南部一家妇女专科医院 2016 年至 2022 年期间的分娩医疗记录进行了回顾性队列研究。基于人口统计学、既往健康和生殖因素，使用倾向评分匹配（PSM）比较了使用医学辅助生殖（MAR）技术受孕的妊娠和未辅助受孕的妊娠。研究结局包括剖宫产、妊娠期糖尿病（GDM）、妊娠高血压疾病（HDP）、分娩并发症和产后再次入院。我们使用泊松回归和稳健标准差生成所有研究结局的风险比（RR）和 95%置信区间（CI）。
在 57354 例分娩中，586 例（1.02%）妊娠采用 MAR 技术，56768 例（98.98%）为非 MAR 妊娠。与非 MAR 组相比，MAR 妊娠的所有研究结局发生率均显著更高，包括 GDM（15.9% vs. 11.2%，p<0.001）、HDP（28.2% vs. 21.1%，p<0.001）、剖宫产（56.1% vs. 34.6%，p<0.001）、分娩并发症（10.9% vs. 6.8%，p=0.03）和产后再次入院（4.3% vs. 2.7%，p=0.02）。在 MAR 为 584 例和非 MAR 为 1727 例的 PSM 样本中，MAR 与剖宫产风险增加相关（RR=1.11，95%CI=1.01-1.22）；而 IVF 与剖宫产风险增加相关（RR=1.15，95%CI=1.03-1.28）和分娩并发症风险增加相关（RR=1.44，95%CI=1.04-2.01）。
MAR 受孕的女性剖宫产风险增加，而 IVF 受孕的女性分娩并发症风险增加。
