Maternal and perinatal outcomes in primiparous singleton pregnancies conceived with assisted reproductive technology in British Columbia

Rebecca Eckler; Yang Doris Liu; Amrita Pooni; Paul J Yong; Sarka Lisonkova; Mohamed A Bedaiwy

doi:10.1016/j.ejogrb.2023.10.010

Maternal and perinatal outcomes in primiparous singleton pregnancies conceived with assisted reproductive technology in British Columbia

Eur J Obstet Gynecol Reprod Biol. 2023 Dec:291:106-111. doi: 10.1016/j.ejogrb.2023.10.010. Epub 2023 Oct 18.

Authors

Rebecca Eckler¹, Yang Doris Liu², Amrita Pooni³, Paul J Yong⁴, Sarka Lisonkova¹, Mohamed A Bedaiwy⁵

Affiliations

¹ Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada.
² Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
³ Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada; Division of Reproductive Endocrinology & Infertility, McGill University Health Care Center, Montreal, QC, Canada.
⁴ Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada; Division of Reproductive Endocrinology & Infertility, University of British Columbia, Vancouver, BC, Canada.
⁵ Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada; Division of Reproductive Endocrinology & Infertility, University of British Columbia, Vancouver, BC, Canada. Electronic address: mohamed.bedaiwy@cw.bc.ca.

PMID: 37862928
DOI: 10.1016/j.ejogrb.2023.10.010

Abstract

Objective: To evaluate the odds of developing adverse maternal and perinatal outcomes in primiparous singleton pregnancies conceived with assisted reproductive technology (ART) compared with pregnancies conceived without ART.

Study design: A retrospective population-based cohort study using data from the British Columbia Perinatal Data Registry. The population included primiparous women with singleton live or stillbirths delivering at or after 20 weeks' gestation between April 1st 2008-March 31st, 2021. Women who conceived with ART were compared with those who conceived without ART. The main outcome measures were gestational diabetes, hypertensive disorders of pregnancy, preterm birth, low birth weight, neonatal intensive care unit admission, stillbirth, and 5-minute Apgar score. Adjusted odds ratios were calculated.

Results: The study population included 191,059 primiparous women: 183,819 conceived without ART, 7,240 conceived using ART. After controlling for age, body mass index, pre-gestational diabetes, and smoking status, singleton pregnancies conceived by ART had significantly higher odds of gestational diabetes (OR 1.18, 95 % confidence interval [CI] 1.10-1.26) and hypertensive disorders of pregnancy (OR 1.39, 95 % CI 1.29-1.51). There were also significantly increased odds of preterm birth (OR 1.35, 95 % CI 1.25-1.46), low birth weight (OR 1.35, 95 % CI 1.23-1.49), and neonatal intensive care unit admission (OR 1.21, 95 % CI 1.11-1.32). There was not a statistically significant difference in the odds of stillbirth (OR 1.06, 95 % CI 0.72-1.57) or 5-minute Apgar score < 7 (OR 1.10, 95 % CI 0.97-1.26).

Conclusion: There is an increased odds of developing several adverse maternal or neonatal outcomes in primiparous singleton pregnancies conceived by ART including gestational diabetes, hypertensive disorders of pregnancy, preterm birth, low birth weight, and increased incidence of neonatal intensive care unit admissions.

Keywords: ART; Assisted reproductive technologies; Maternal complications; Neonatal complications; Primiparity; Singleton pregnancy; Spontaneous conception.

MeSH terms

British Columbia
Cohort Studies
Diabetes, Gestational* / epidemiology
Female
Humans
Hypertension, Pregnancy-Induced* / epidemiology
Hypertension, Pregnancy-Induced* / etiology
Infant, Newborn
Pregnancy
Pregnancy Outcome / epidemiology
Premature Birth* / epidemiology
Premature Birth* / etiology
Reproductive Techniques, Assisted / adverse effects
Retrospective Studies
Stillbirth / epidemiology