Department of Evolutionary Anthropology, University of Vienna, Vienna, Austria.
Department of Gynecology and Obstetrics, Clinic Donaustadt, Vienna, Austria.
J Biosoc Sci. 2024 Sep;56(5):920-924. doi: 10.1017/S0021932024000130. Epub 2024 Mar 27.
Assisted reproductive technologies (ARTs) such as in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI) are still discussed critically, as there is no consensus on whether these treatments could be the cause of risk factors for obstetric problems such as breech presentation. The aim of this study was to test the association between ART and breech presentation among 11920 singleton term births taking place in Vienna from 2010 to 2020. In this single-centre medical record-based study, data concerning the conception mode (spontaneous versus IVF or ICSI), child presentation, birth mode, newborn sex and size as well as age, height, weight, and reproductive history of the mother were included. Three hundred twenty-six newborns (2.7%) were conceived by IVF or ICSI, and 527 newborns (4.4%) were delivered in breech presentation. Breech presentation occurred in 7.6% of IVF/ICSI children but only in 4.3% of spontaneously conceived children ( = 0.019). ART increased the crude risk of breech presentation significantly (OR = 1.67; 95% CI 1.71 - 2.38). After adjusting for maternal age, height, number of previous births, smoking, and newborn sex, however, ART had no longer a significant impact on the risk of breech presentation. In contrast, breech presentation was significantly associated with higher maternal age as well as a lower number of previous births, but not with ART. This study shows that the adverse outcomes of IVF and ICSI pregnancies may not be due to the ART treatment alone but might also be due to the mostly higher age and lower parity of the mothers using ART.
辅助生殖技术(ART),如体外受精(IVF)和卵胞浆内单精子注射(ICSI),仍在受到批评,因为人们对于这些治疗方法是否会导致产科问题的风险因素(如臀位)还没有达成共识。本研究的目的是在维也纳 2010 年至 2020 年期间的 11920 例足月单胎分娩中,检验 ART 与臀位的关系。在这项单中心病历研究中,纳入了关于受孕方式(自然受孕与 IVF 或 ICSI)、胎儿先露、分娩方式、新生儿性别和大小以及母亲年龄、身高、体重和生殖史的数据。326 名新生儿(2.7%)通过 IVF 或 ICSI 受孕,527 名新生儿(4.4%)臀位分娩。IVF/ICSI 新生儿中臀位的发生率为 7.6%,而自然受孕新生儿中臀位的发生率仅为 4.3%(=0.019)。ART 显著增加了臀位的粗风险(OR=1.67;95%CI 1.71-2.38)。然而,在调整了母亲年龄、身高、既往分娩次数、吸烟和新生儿性别后,ART 对臀位的发生风险不再有显著影响。相比之下,臀位与母亲年龄较大以及既往分娩次数较少显著相关,但与 ART 无关。本研究表明,IVF 和 ICSI 妊娠的不良结局可能不仅仅是由于 ART 治疗本身,还可能与使用 ART 的母亲年龄较大和生育次数较少有关。