Eliner Or, Koren Roni Rahav, Ram Hila Shalev, Levi Mattan, Haikin Herzberger Einat, Wiser Amir, Miller Netanella
IVF Unit-In Vitro Fertilization Unit, Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba 4428164, Israel.
School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv 6997801, Israel.
Children (Basel). 2024 Aug 10;11(8):962. doi: 10.3390/children11080962.
BACKGROUND/OBJECTIVES: Although high live birth rates are associated with oocyte donation (OD), these pregnancies are associated with increased obstetric and perinatal risks. This study evaluated maternal and neonatal risks after OD compared to in vitro fertilization (IVF) with autologous oocytes, and to spontaneous pregnancies (SPs), among singletons, twins and triplets.
A retrospective, large, population-based cohort study was conducted based on electronic data from Maccabi Healthcare Services. A total of 469,134 pregnancies were grouped according to the mode of conception. The main outcome measures were preterm birth (PTB), small for gestational age (SGA) and pregnancy-induced hypertension (PIH). The data were analyzed separately for singletons, twins and triplets.
The mean maternal age was older in the OD group compared with the IVF and SP groups (singletons: 39.7 ± 4.1 vs. 34.5 ± 4.8 and 31.7 ± 5.3 years; twins: 39 ± 4.6 vs. 32.6 ± 4.4 and 31.2 ± 5.1 years; and triplets: 35.6 ± 2.5 vs. 32 ± 3.9 and 29.7 ± 5 years). The mean gestational age was younger among the OD group compared to the SP group (singletons: 37.5 ± 3 vs. 39 ± 2 = 0.001, and twins: 35 ± 3 vs. 36 ± 2.5 = 0.001). Higher rates of PTB < 37, PTB < 34 and PTB < 28 weeks were found among OD singletons. Multivariable logistic regressions for PTB < 37 weeks and SGA in singletons demonstrated that OD and IVF are significant risk factors (OR = 4.1, 95%CI = 3.3-5.2; OR = 4.3, 95%CI = 4.1-4.6; OR = 1.9, 95%CI = 1.3-2.6; OR = 2.2, 95%CI = 2-2.4, respectively). Significantly higher rates of PIH were demonstrated among the OD vs. IVF and SP groups in singleton (4.3% vs. 1.7% and 0.7%) and in twin pregnancies (7.5% vs. 4.3% and 3.4%).
OD pregnancies are at increased risk for PTB, SGA and PIH.
背景/目的：尽管高活产率与卵母细胞捐赠（OD）相关，但这些妊娠与产科及围产期风险增加有关。本研究评估了单胎、双胎和三胎妊娠中，与自体卵母细胞体外受精（IVF）及自然妊娠（SP）相比，卵母细胞捐赠后的母婴风险。
基于Maccabi医疗服务机构的电子数据进行了一项回顾性、大型、基于人群的队列研究。根据受孕方式将总共469,134例妊娠进行分组。主要结局指标为早产（PTB）、小于胎龄儿（SGA）和妊娠期高血压（PIH）。分别对单胎、双胎和三胎的数据进行分析。
与IVF组和SP组相比，OD组的平均产妇年龄更大（单胎：39.7±4.1岁 vs. 34.5±4.8岁和31.7±5.3岁；双胎：39±4.6岁 vs. 32.6±4.4岁和31.2±5.1岁；三胎：35.6±2.5岁 vs. 32±3.9岁和29.7±5岁）。与SP组相比，OD组的平均孕周更小（单胎：37.5±3周 vs. 39±2周，P = 0.001；双胎：35±3周 vs. 36±2.5周，P = 0.001）。在OD单胎妊娠中，发现<37周、<34周和<28周的早产发生率更高。单胎妊娠中<37周早产和SGA的多变量逻辑回归显示，OD和IVF是显著的危险因素（OR分别为4.1，95%CI = 3.3 - 5.2；OR为4.3，95%CI = 4.1 - 4.6；OR为1.9，95%CI = 1.3 - 2.6；OR为2.2，95%CI = 2 - 2.4）。在单胎妊娠（4.3% vs. 1.7%和0.7%）和双胎妊娠（7.5% vs. 4.3%和3.4%）中，OD组的PIH发生率显著高于IVF组和SP组。
OD妊娠发生PTB、SGA和PIH的风险增加。
