Effect of ART treatments on maternal and neonatal outcomes in singleton live births: A large-scale retrospective cohort study
Qi Zhang,
Xiaoni Guo,
Feng Zhou,
Qian Luo,
Deying He,
Xi Qian,
Li Hong Wu,
Xiaodong Zhang,
Guoning Huang,
Wei Zhou
Affiliations
Qi Zhang
Chongqing Health Center for Women and Children, Chongqing, China; Women and Children's Hospital of Chongqing Medical University, Chongqing, China; Chongqing Clinical Research Center for Reproductive Medicine, Chongqing, China
Xiaoni Guo
Chongqing Health Center for Women and Children, Chongqing, China; Women and Children's Hospital of Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Human Embryo Engineering and Precision Medicine, Chongqing, China
Feng Zhou
Chongqing Health Center for Women and Children, Chongqing, China; Women and Children's Hospital of Chongqing Medical University, Chongqing, China
Qian Luo
Chongqing Health Center for Women and Children, Chongqing, China; Women and Children's Hospital of Chongqing Medical University, Chongqing, China
Deying He
Chongqing Health Center for Women and Children, Chongqing, China; Women and Children's Hospital of Chongqing Medical University, Chongqing, China
Xi Qian
Chongqing Health Center for Women and Children, Chongqing, China; Women and Children's Hospital of Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Human Embryo Engineering and Precision Medicine, Chongqing, China
Li Hong Wu
Chongqing Health Center for Women and Children, Chongqing, China; Women and Children's Hospital of Chongqing Medical University, Chongqing, China
Xiaodong Zhang
Chongqing Health Center for Women and Children, Chongqing, China; Women and Children's Hospital of Chongqing Medical University, Chongqing, China; Chongqing Clinical Research Center for Reproductive Medicine, Chongqing, China; Corresponding author. Chongqing Health Center for Women and Children, No. 64 Jin Tang Street, Yu Zhong District, Chongqing 400013, China.
Guoning Huang
Chongqing Health Center for Women and Children, Chongqing, China; Women and Children's Hospital of Chongqing Medical University, Chongqing, China; Chongqing Clinical Research Center for Reproductive Medicine, Chongqing, China; Corresponding author. Chongqing Health Center for Women and Children, No. 64 Jin Tang Street, Yu Zhong District, Chongqing 400013, China.
Wei Zhou
Chongqing Health Center for Women and Children, Chongqing, China; Women and Children's Hospital of Chongqing Medical University, Chongqing, China; Corresponding author. Chongqing Health Center for Women and Children, No. 120 Longshan Road, Yu Bei District, Chongqing 401120, China.
Background: 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. Methods: 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. Results: 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 (0.44–0.89)), 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. Conclusions: 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.
