Obstetrical And Perinatal Outcomes Following Assisted Reproductive Technology: A Retrospective Cohort Study

Objective:The aim of this study was to compare adverse pregnancy outcomes between women underwent artificial insemination and compared with women underwent natural fertilization,focusing on the pregnancy complications,delivery,and neonatal outcomes.Material/Methods:This retrospective cohort study analyzed single births of pregnancies conceived by artificial insemination(N=496)in2013-2018 compared to natural fertilization(N=496)in the First Bethune Hospital of Jilin University,according to the method of 1:1 age + gestational number matching.The age difference of each Random pairing group was within 0.1 year.The average age was 32.85 ± 3.98 years old in ART group,and in control group was 32.63 ± 4.124(P = 0.381).Through medical records and telephone follow-up,the data of complications during pregnancy,complications during delivery and delivery mode were obtained.SPSS 22.0 and stata12.0 statistical software were used to analyze the data.The c2 test was used to compare the rate,and the t test was used to compare the mean data.The adjusted odds ratio(OR)and 95% CI were used to assess the relative risk of adverse pregnancy outcomes.Multivariate logistic regression was used to adjust the effect of age,pregnancy,delivery and previous cesarean section on the outcome.P-value <0.05 was considered statistically significant.Results:1.Summarize the general situation of pregnant women:the pregnant women in ART group were more likely to have first pregnancy,first delivery,high cesarean section rate,previous low cesarean section history and low induced abortion history.2.Pregnant women who get pregnant through artificial insemination are more likely to suffer from complications during pregnancy.The incidence of preeclampsia increased in ART group(OR,1.886,95% CI 1.176-3.025).There were significant differences between the two groups.The incidence of GDM and ICP in ART group and natural fertilization group were not different.3.Placental adhesion(OR,2.211,95% CI 1.681-2.909)was more likely to occur in ART pregnancy.The incidence of uterine contraction weakness leading to postpartum hemorrhage in ART group was higher than that in natural fertilization group(P= 0.002).There was no difference in the incidence of placenta previa,placental abruption,premature rupture of fetal membranes,umbilical cord insertion site abnormality and amniotic fluid volume abnormality between ART group and natural fertilization group.4.About 21% of the patients in ART group and natural fertilization pregnancies group were transferred to neonatology for observation or treatment.Among them,the hospitalization days of the newborns in ART group were significantly longer than those in natural fertilization group(P = 0.017).There was no difference between the two groups in malformation rate.Conclusion:Assisted reproductive technology is closely related to pregnancy induced preeclampsia,cesarean delivery,postpartum hemorrhage and placenta adhesion,and long hospitalization time of newborn.There is still a need for further research and development on ART.Before that,it is necessary to apply it cautiously,carry out single embryo transfer,carry out regular prenatal examination,terminate pregnancy at the right time and pay close attention on the growth and development of the offspring.