Maternal And Child Outcome After In Vitro Fertilization And Embryo Transfer

Background and objective: As assisted reproductive technology has become one of the effective treatments for infertility,the birth rate via in vitro fertilization and embryo transfer for 1% of the birth rate of newborn babies in China [2].While IVF-ET pregnancy brings new life,the safety of the technology and the life and health of the offspring have attracted extensive attention in the medical field.This paper retrospectively analyzed the differences of pregnancy complications and neonatal outcomes between IVF-ET pregnancy and natural pregnancy,so as to provide theoretical basis for IVF-ET pregnancy related perinatal health care,prevention and monitoring of pregnancy complications.Methods: In this study,a retrospective cohort study was conducted to collect a total of 718 pregnant women who delivered IVF-ET pregnancy in our obstetric department from January 2018 to December 2019,and a total of 2154 naturally pregnant women who delivered in our obstetric department during the same period were selected as the control group in a 1:3 matched and completely random selection.According to the inclusion and exclusion criteria,a total of 692 IVF-ET pregnant women who met the statistical criteria,and there were 2139 pregnant women in the control group.The sociological characteristics of pregnant women,Pregnancy complications,perinatal complications,and neonatal outcomes were investigated and analyzed by statistical.Then,according to the number of fetuses and the age of pregnant women,the subgroups were analyzed for pregnancy complications and neonatal adverse pregnancy outcomes.Results: In the age < 35 years old group,the risk of placenta previa in IVF-ET pregnancy gestational diabetes is 1.71 times that of spontaneous pregnancy(aOR = 1.71,95% CI 1.21-2.42).The risk of hypertensive disorder complicating pregnancy is 1.85 times that of spontaneous pregnancy(aOR = 1.85,95% CI 1.16-2.95).The risk of preeclampsia is 2.73 times that of natural pregnancy(aOR = 2.73,95% CI 1.56-4.77).The risk of premature birth is 1.78 times that of natural pregnancy(aOR = 1.78,95% CI 1.24-2.56).The risk of placenta previa is 3.22 times that of spontaneous pregnancy(aOR=3.22,95% CI 1.53-6.79).Compared with spontaneous pregnancy,the incidence of intrahepatic cholestasis of pregnancy(P=0.84),placental abruption(P=1.00)and premature rupture of membranes(P=0.15)in IVF-ET pregnancy had no statistical difference.In the age > 35 years old group,the risk of placenta previa in IVF-ET pregnancy was 5.81 times higher than that in spontaneous pregnancy(aOR=5.81,95% CI 1.89-17.90).Compared with spontaneous pregnancy,there were no statistically significant differences in the incidence of gestational diabetes mellitus(P=0.13),gestational hypertension disease(P=0.05),preeclampsia(P=0.08),intrahepatic cholestasis(P=1.00),preterm delivery(P=0.09),premature rupture of membranes(P=0.99),and placental abruption in IVF-ET pregnancy.In the singleton pregnancy group,the risk of hypertensive disorder complicating pregnancy in IVF-ET pregnancy was 2.40 times that of spontaneous pregnancy(aOR = 2.40,95% CI 1.53-3.76).The risk of preeclampsia in IVF-ET pregnancy is 3.88 times that of spontaneous pregnancy(aOR = 3.88,95% CI 2.23-6.75).The risk of premature birth in IVF-ET pregnancy is 3.15 times that of spontaneous pregnancy(aOR = 3.15,95% CI 2.14-4.65).The risk of placenta previa in IVF-ET pregnancy is 3.21 times that of spontaneous pregnancy(aOR=3.21,95% CI 1.64-6.29).Compared with patients with spontaneous pregnancy,the incidence of intrahepatic cholestasis of pregnancy(P=0.58),premature rupture of membranes(P=0.22)and placental abruption(P=0.99) in gestational diabetes mellitus(P = 0.29)in IVF-ET pregnancy had no statistical difference.In the twin-pregnancy group,there were no significant differences in the incidence of gestational diabetes mellitus(P=0.40),gestational hypertensive disease(P= 0.69),preeclampsia(P=0.54),intrahepatic cholestasis(P=0.31),preterm delivery(P= 0.95),placenta previa(P=1.00),placental abruption,and premature rupture of membrane(P=0.98)in the IVF-ET twin-pregnancy group compared with spontaneous pregnancy.In the age < 35 years old group,compared with spontaneous pregnancy,there were no significant differences in the incidence of low birth weight(P= 0.61),macrosomia(P=0.10),birth defects(P= 0.43)and neonatal death(P= 0.28)in IVF-ET pregnancy group.In the age >35 years old group,there were no significant differences in the incidence of low birth weight(P= 0.49),macrosomia(P=0.31),birth defects(P= 0.41)and neonatal death(P=1.00)in IVF-ET pregnancy compared with spontaneous pregnancy.In the singleton pregnancy group,the risk of low birth weight infants in IVF-ET pregnancy was 2.92 times that of spontaneous pregnancy(aOR = 2.92,95% CI 1.80-4.72).The risk of macrosomia in IVF-ET pregnancy is 1.64 times that of natural pregnancy(OR=1.64,95% CI 1.10-2.45).Compared with spontaneous pregnancy,the incidence of neonatal birth defects(P=0.73)and neonatal death(P=0.99)in IVF-ET pregnancy had no significant difference.In the twin pregnancies group: the incidence of low birth weight in IVF-ET pregnancy was lower than that of spontaneous pregnancy,and the difference was statistically significant(P=0.03).There was no statistically significant difference in the incidence of birth defects(P=0.16)and neonatal death(P=0.42)in IVF-ET pregnancy compared with spontaneous pregnancy.Conclusion:Compared with spontaneous pregnancy,IVF-ET pregnancy has an increased risk of pregnancy complications,mainly including preeclampsia,preterm delivery and placenta previa.IVF-ET pregnancy management and monitoring should be strengthened,focusing on the prevention of preeclampsia,preeclampsia and placenta location in late pregnancy,so as to achieve early identification and early intervention of pregnancy complications.IVF-ET twin-pregnancy has a higher incidence of gestational complications than spontaneous pregnancy,and single embryo transfer is recommended.