Deng Qi, Ji Ting, Chu Guanghua, Tan Hongwei
Department of Obstetrics and Gynaecology, Northwest Women's and Children's Hospital, Xi'an, 710061, People's Republic of China.
Int J Womens Health. 2025 Aug 5;17:2443-2449. doi: 10.2147/IJWH.S538128. eCollection 2025.
To evaluate maternal and neonatal outcomes following assisted reproductive technology (ART) in advanced maternal age (AMA) primiparous women.
This retrospective cohort study analyzed 2329 AMA primiparous women (≥35 years) who delivered singleton pregnancies at Northwest Women's and Children's Hospital between January 2016 and January 2020. Participants were stratified into ART (n=422) and spontaneous conception (SC, n=1907) groups. Maternal characteristics, obstetric complications, and neonatal outcomes were compared using multivariate logistic regression to adjust for confounders.
ART patients exhibited significantly higher maternal age (37.48 ± 2.44 vs 36.65 ± 1.90 years, p < 0.001) and BMI (27.79 ± 3.34 vs 27.61 ± 8.12 kg/m², p = 0.016). ART was independently associated with increased risks of preeclampsia (adjusted odds ratio [aOR] 1.89, 95% confidence interval [CI] 1.25-2.86), cesarean delivery (aOR 2.31, 95% CI 1.74-3.06), preterm birth (aOR 1.55, 95% CI 1.10-2.19), and neonatal intensive care unit (NICU) admission (aOR 2.38, 95% CI 1.68-3.37). Conversely, SC pregnancies showed higher rates of preterm premature rupture of membranes (PPROM; 26.43% vs 17.30%, p < 0.001). No significant differences were observed in gestational diabetes mellitus (33.18% vs 31.31%, p = 0.455) or placental abruption (0.95% vs 1.42%, p = 0.313).
In AMA primiparas, ART selectively elevates risks of preeclampsia and neonatal morbidity, necessitating targeted antenatal surveillance. These findings underscore the importance of preconception counseling and individualized management for this growing patient population.
评估高龄初产妇辅助生殖技术（ART）后的母婴结局。
这项回顾性队列研究分析了2016年1月至2020年1月在西北妇女儿童医院分娩单胎妊娠的2329名高龄初产妇（≥35岁）。参与者被分为ART组（n = 422）和自然受孕（SC，n = 1907）组。使用多因素逻辑回归比较母体特征、产科并发症和新生儿结局，以调整混杂因素。
ART组患者的产妇年龄（37.48±2.44岁 vs 36.65±1.90岁，p<0.001）和体重指数（BMI）（27.79±3.34 vs 27.61±8.12 kg/m²，p = 0.016）显著更高。ART与子痫前期风险增加（调整后的优势比[aOR] 1.89，95%置信区间[CI] 1.25 - 2.86）、剖宫产（aOR 2.31，95% CI 1.74 - 3.06）、早产（aOR 1.55，95% CI 1.10 - 2.19）以及新生儿重症监护病房（NICU）入院（aOR 2.38，95% CI 1.68 - 3.37）独立相关。相反，SC妊娠的胎膜早破早产（PPROM）发生率更高（26.43% vs 17.30%，p<0.001）。妊娠期糖尿病（33.18% vs 31.31%，p = 0.455）或胎盘早剥（0.95% vs 1.42%，p = 0.313）方面未观察到显著差异。
在高龄初产妇中，ART选择性地增加了子痫前期和新生儿发病的风险，需要进行有针对性的产前监测。这些发现强调了对这一不断增长的患者群体进行孕前咨询和个体化管理的重要性。
