Eshkoli Tamar, Atzmon Tal, Rotem Reut, Weintraub Adi Y, Baumfeld Yael, Steiner Naama
Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Department of Obstetrics and Gynecology, Soroka University Medical Center, Beer-Sheva, Israel.
Arch Gynecol Obstet. 2025 Sep 8. doi: 10.1007/s00404-025-08183-4.
To investigate adverse pregnancy and delivery outcomes in women with GDMA1 during pregnancies conceived through fertility treatments.
This population-based retrospective cohort study examined adverse pregnancy and delivery outcomes in pregnancies affected by GDMA1 following fertility treatments compared to those conceived naturally. Women with GDMA1 who conceived via fertility treatments were classified as cases, while those who conceived naturally were designated as controls. Multivariable logistic regression models were employed to evaluate the association between fertility treatments and perinatal outcomes in pregnancies complicated by GDMA1.
The study cohort consisted of 12,841 pregnant women diagnosed with GDMA1, of whom 640 (4.98%) conceived through fertility treatments, while the remaining 12,201 conceived naturally. Women with GDMA1 who conceived through fertility treatments had significantly higher rates of preeclampsia, hypertension, preterm birth, and cesarean delivery, while they experienced lower rates of macrosomia and polyhydramnios compared with women who conceived spontaneously. Multivariate analysis identified fertility treatments as an independent predictor of cesarean delivery, while conversely serving as a protective factor against macrosomia after adjusting for maternal age, parity, hypertensive disorders of pregnancy, and labor induction.
Women with GDMA1 who conceived through fertility treatments experienced a reduced incidence of complications associated with GDM, such as macrosomia and polyhydramnios. This could be explained by better GDM control and adherence to a more rigorous prenatal care approach. However, they faced an increased risk of other obstetric complications, including pre-eclampsia, preterm delivery, and cesarean delivery.
探讨妊娠合并妊娠糖尿病A级1型（GDMA1）的女性在接受辅助生殖治疗后的不良妊娠及分娩结局。
本基于人群的回顾性队列研究，比较了妊娠合并GDMA1的女性在接受辅助生殖治疗后的不良妊娠及分娩结局与自然受孕者的差异。将通过辅助生殖治疗受孕的GDMA1女性归为病例组，自然受孕者为对照组。采用多变量逻辑回归模型评估辅助生殖治疗与妊娠合并GDMA1的围产期结局之间的关联。
研究队列包括12841例诊断为GDMA1的孕妇，其中640例（4.98%）通过辅助生殖治疗受孕，其余12201例自然受孕。与自然受孕的女性相比，通过辅助生殖治疗受孕的GDMA1女性子痫前期、高血压、早产和剖宫产的发生率显著更高，而巨大儿和羊水过多的发生率较低。多因素分析确定辅助生殖治疗是剖宫产的独立预测因素，而在调整产妇年龄、产次、妊娠高血压疾病和引产因素后，辅助生殖治疗是巨大儿的保护因素。
通过辅助生殖治疗受孕的GDMA1女性，与妊娠期糖尿病相关的并发症如巨大儿和羊水过多的发生率降低。这可能是由于更好地控制了妊娠期糖尿病以及坚持了更严格的产前检查方法。然而，她们面临其他产科并发症的风险增加，包括子痫前期、早产和剖宫产。
