Obstetric outcomes in women of advanced maternal age after assisted reproduction

Abstract

Background: Pregnancy and deliveries resulting from assisted reproductive technology (ART) in women of advanced maternal age (AMA) are reported to be associated with adverse maternal and perinatal outcomes. The aim of the study was to investigate the impact of a combination of AMA and assisted reproduction on obstetric and perinatal outcomes of nulliparous singleton pregnancies. Methods: Medical records of 201 live-born singletons, cephalic, non-anomalous nulliparous pregnancies were reviewed retrospectively. The IVF conception (90 AMA women after ART) and spontaneous conception (111 AMA women with spontaneous pregnancy) groups were formed. Results: Intrauterine growth restriction, nonreassuring fetal state, operative vaginal delivery, cesarean section, induction of labor, and massive obstetric hemorrhage were more common in AMA patients after ART compared with the spontaneous conception group. The incidence of preeclampsia and nonreassuring fetal status during pregnancy in the IVF conception group was more than 2 times higher than that in the spontaneous conception group. There were no significant differences in spontaneous preterm delivery, Apgar scores, and neonatal morbidity rates between the study groups. Discussion: Nulliparous AMA women with pregnancies obtained after ART have inherently higher risks of severe adverse maternal and perinatal outcomes and require careful dynamic monitoring of mother’s and fetal conditions followed by prevention and, if possible, correction of disorders during pregnancy and delivery.

Keywords

• nulliparity
• pregnancy complication
• adverse maternal outcomes
• adverse perinatal outcomes