The Resultes Of In Vitro Fertilizationg And Embryo Transfer Pregnancy In Late Pregnancy And Delivery

Objective: A retrospective case-control study was conducted to invstigate the relationship between IVF-ET and adverse pregnancy outcomes by comparing pregnancy complications,intrapartum complications,placental membrane abnormalities and neonatai outcomes after excluding the effects of gravida,parity,body mass index,previous cesarean section and age.Methods: We select a total of 366 IVF-ET pregnant women who gave birth to in The Second Hospital of Hebei Medical University from January 2008 to December 2017 and 732 natural pregnant women who gave birth to in the same hospital during the same period were randomly selected according to the 1:2 age matching method as the control group.All the parturient women included in the subgroups were in line with the gestational weeks of more than 28 weeks and were in live birth,and the following conditions were excluded: donor oocyte,PGD pregnancy,combined with chronic diseases,diagnosed with hypertension before 20 weeks of pregnancy,combined with pre-pregnancy diabetes or heart diseases,genital malformation and fetal deformity.We obtain necessary informations through medical records and telephone return visits to explore the correlation between IVF-ET technique and adverse pregnancy outcomes and its possible mechanism by comparing the pregnancy outcomes of IVF-ET group and natural pregnancy group.Results:1.There was no significant differences in age between the two groups(P=0.995).Compared with the natural pregnancy group,IVF-ET group showed first pregnancy(P<0.001),first labor(P<0.001),high cesarean section rate(P<0.001),high body mass index(P<0.001),and multiple pregnancies(P<0.001).2.There was no significant difference between the IVF-ET group and the natural pregnancy group in gestational diabetes mellitus and intrahepatic cholestasis during pregnancy(P values were 0.633 and 0.060,respectively),but IVF-ET group was more likely to develop new hypertension during pregnancy than the natural pregnancy group(P<0.05).However,after the effect of multiple pregnancies was excluded,there was no significant difference between the two groups(P=0.472).In IVF-ET group,the incidence of new hypertension,intrahepatic cholestasis during pregnancy and premature rupture of membranes before full term was higher in multiple pregnancies than in single pregnancies(all the P <0.05).3.In aspects of intrapartum complication,abnormal placenta and abnormal fetal membrane,no obvious abnormalities were found in the incidence rate of placental abruption in the two groups(P=0.411),but the incidence rate of placental location abnormalities,placenta increta,preterm premature rupture of the membranes,postpartum hemorrhage and abnormal umbilical cord insertion was significantly higher in IVF-ET group than in the natural pregnancy group(all the P<0.05).And in IVF-ET group,the incidence rate of preterm premature rupture of membranes was higher in multiple pregnancies than in single pregnancies,P = 0.005,the difference was statistically significant.After excluding the effect of multiple pregnancies,there was no statistically significant difference between the two groups(P=0.167).4.In the side of neonatal outcomes,there were significant differences between the two groups in terms of gestational age,birth weight,neonatal asphyxia and admission to NICU.In IVF-ET group,premature infants and low birth weight infants were more likely to occur with P<0.001.Infants in this group was more likely to occur neonatal asphyxia and be in NICU.However,there was no significant difference between the two groups after excluding the effect of gestational pregnancy number.Conclusions:1.Pregnancy after IVF-ET is mostly the first pregnancy,primiparity,more prone to multiple pregnancy and cesarean section to terminate the pregnancy;2.Compared with natural pregnancy,pregnancy after IVF-ET has a higher incidence rate of complications,especially the incidence of placental location abnormalities and placenta implantation.3.Adverse outcomes of neonatal in IVF-ET group were more likely to occur,including preterm birth,low birth weight,neonatal asphyxia,and higher risk of transfer to NICU,multiple pregnancy is the main causes.