Hu Miao, Du Lili, Zhang Lizi, Lin Lin, Zhang Yuliang, Gu Shifeng, Gu Zhongjia, Liang JingYing, Lai Siying, Liu Yu, Huang Minshan, Huang Yuanyuan, Huang Qingqing, Luo Shijun, Zhang Shuang, Chen Dunjin
Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, The Third Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China.
Reprod Health. 2025 May 19;22(1):85. doi: 10.1186/s12978-025-02031-z.
IVF/ICSI is associated with an increased risk of placenta accreta spectrum disorders (PAS). Invasive PAS can result in significant adverse maternal and fetal outcomes. This study investigates the impact of IVF/ICSI on the severity grading of PAS and its correlation with pregnancy complications.
Placenta accreta spectrum disorders (PAS) patients who underwent cesarean section at a single clinical center from January 2018 to March 2023 were retrospectively included in this study. Baseline characteristics and outcomes were compared between the IVF/ICSI group (154 cases) and the spontaneous conception group (820 cases). Binary logistic regression was used to explore the risk factors associated with adverse outcomes related to IVF/ICSI. A 1:1 ratio propensity score matching (PSM) was conducted to minimize selection bias between the two groups (123 cases per group). Data analysis was performed using SPSS (version 25.0) software.
PAS grading is not associated with IVF/ICSI (OR = 0.76, 95%CI: 0.45 ~ 1.27, P = 0.290). In contrast, a significant risk factor for postpartum hemorrhage (OR = 9.20, 95%CI: 2.68 ~ 9.22, P < 0.001) and red cells transfusion ≥ 4U (OR = 3.71,95%CI:1.21 ~ 11.33, P = 0.021) was observed in IVF/ICSI group. No additional adverse pregnancy outcomes arose as a result of IVF/ICSI.
IVF/ICSI does not increase the depth of placental implantation in patients with placenta accreta spectrum (PAS); however, it is associated with a higher risk of postpartum hemorrhage and the need for blood transfusion. In clinical practice, special attention should be given to the prenatal management of these patients, along with ensuring adequate blood product reserves during delivery.
体外受精/卵胞浆内单精子注射（IVF/ICSI）与胎盘植入谱系疾病（PAS）风险增加相关。侵袭性PAS可导致严重的母婴不良结局。本研究调查IVF/ICSI对PAS严重程度分级的影响及其与妊娠并发症的相关性。
回顾性纳入2018年1月至2023年3月在单一临床中心行剖宫产的胎盘植入谱系疾病（PAS）患者。比较IVF/ICSI组（154例）和自然受孕组（820例）的基线特征和结局。采用二元逻辑回归探索与IVF/ICSI相关不良结局的危险因素。进行1:1倾向评分匹配（PSM）以最小化两组间的选择偏倚（每组123例）。使用SPSS（25.0版）软件进行数据分析。
PAS分级与IVF/ICSI无关（OR = 0.76，95%CI：0.45～1.27，P = 0.290）。相比之下，IVF/ICSI组观察到产后出血（OR = 9.20，95%CI：2.68～9.22，P < 0.001）和红细胞输注≥4U（OR = 3.71，95%CI：1.21～11.33，P = 0.021）的显著危险因素。IVF/ICSI未导致额外的不良妊娠结局。
IVF/ICSI不会增加胎盘植入谱系（PAS）患者的胎盘植入深度；然而，它与产后出血风险较高和输血需求相关。在临床实践中，应特别关注这些患者的产前管理，并在分娩期间确保充足的血液制品储备。
