Zhang Qi, Guo Xiaoni, Zhou Feng, Luo Qian, He Deying, Qian Xi, Wu Li Hong, Zhang Xiaodong, Huang Guoning, Zhou Wei
Chongqing Health Center for Women and Children, Chongqing, China.
Women and Children's Hospital of Chongqing Medical University, Chongqing, China.
Heliyon. 2024 Aug 30;10(17):e37211. doi: 10.1016/j.heliyon.2024.e37211. eCollection 2024 Sep 15.
The increased risk of pregnancy complications in the ART population has been reported, but the source of these risks remains controversial. The study aims to evaluate the association between ART treatments and patient characteristics with maternal and neonatal outcomes.
This was a retrospective analysis of 45,159 singleton pregnant women at a hospital between 2018 and 2021. The maternal and neonatal outcomes included pregnancy-induced hypertension (PIH), preeclampsia (PE), gestational diabetes mellitus (GDM), placental abruption (PA), placenta accreta spectrum (PAS), postpartum hemorrhage (PPH), cesarean section, iatrogenic and spontaneous preterm birth, small for gestational age (SGA), low birth weight (LBW), macrosomia, and birth defects. We assessed the outcomes among the fresh embryo transfer (ET), frozen embryo transfer (FET), and spontaneous conception (SC) groups. Potential risk factors were further analyzed in the ART population.
FET was associated with higher risks for PIH (SC: AOR, 1.97(1.51-2.57); fresh ET: AOR, 1.68(1.03-2.72)), PE (SC: 2.28(1.86-2.80); fresh ET: AOR, 1.61(1.11-2.33)), PAS (SC: AOR, 3.89(3.39-4.46); fresh ET: AOR, 2.23(1.70-2.92)), PPH (SC: AOR, 3.46(2.76-4.34)); fresh ET: 2.09(1.39-3.14)), and macrosomia (SC: 1.53(1.25-1.86); fresh ET: AOR, 2.87(1.89-4.35). Fresh ET was associated with higher risks for PA (SC: AOR, 2.19(1.51-3.18); FET: AOR, 0.39(0.17-0.90)), SGA (SC: AOR, 1.56(1.06-2.31), FET: AOR, 0.42(0.19-0.91)), and LBW (SC: AOR, 2.24(1.82-2.77), FET: AOR, 0.63 (0.440.89)), and fresh ET is an independent risk factor for PA and SGA. Furthermore, the risk of GDM was associated with the biological characteristic of low-fertility patients.
Embryo status (fresh or frozen) is a key factor affecting the maternal and neonatal outcomes in ART treatments, while biological characteristics of infertile patients also play a certain role.
有报道称辅助生殖技术（ART）人群中妊娠并发症的风险增加，但这些风险的来源仍存在争议。本研究旨在评估ART治疗及患者特征与母婴结局之间的关联。
这是一项对2018年至2021年期间某医院45159名单胎孕妇的回顾性分析。母婴结局包括妊娠期高血压（PIH）、子痫前期（PE）、妊娠期糖尿病（GDM）、胎盘早剥（PA）、胎盘植入谱系疾病（PAS）、产后出血（PPH）、剖宫产、医源性和自发性早产、小于胎龄儿（SGA）、低出生体重（LBW）、巨大儿和出生缺陷。我们评估了新鲜胚胎移植（ET）、冷冻胚胎移植（FET）和自然受孕（SC）组的结局。对ART人群中的潜在风险因素进行了进一步分析。
FET与PIH（SC：调整后比值比[AOR]，1.97[1.51 - 2.57]；新鲜ET：AOR，1.68[1.03 - 2.72]）、PE（SC：2.28[1.86 - 2.80]；新鲜ET：AOR，1.61[1.11 - 2.33]）、PAS（SC：AOR，3.89[3.39 - 4.46]；新鲜ET：AOR，2.23[1.70 - 2.92]）、PPH（SC：AOR，3.46[2.76 - 4.34]；新鲜ET：2.09[1.39 - 3.14]）和巨大儿（SC：1.53[1.25 - 1.86]；新鲜ET：AOR，2.87[1.89 - 4.35]）的较高风险相关。新鲜ET与PA（SC：AOR，2.19[1.51 - 3.18]；FET：AOR，0.39[0.17 - 0.90]）、SGA（SC：AOR，1.56[1.06 - 2.31]，FET：AOR，0.42[0.19 - 0.91]）和LBW（SC：AOR，2.24[1.82 - 2.77]，FET：AOR，0.63[0.44 - 0.89]）的较高风险相关，且新鲜ET是PA和SGA的独立危险因素。此外，GDM的风险与低生育力患者的生物学特征相关。
胚胎状态（新鲜或冷冻）是影响ART治疗中母婴结局的关键因素，而不孕患者的生物学特征也起一定作用。
