Maternal and neonatal outcomes following in vitro fertilization: A cohort study in Romania

Andreea Mădălina Bănică; Simona Daniela Popescu; Simona Vlădăreanu

doi:10.3892/etm.2021.10956

Maternal and neonatal outcomes following in vitro fertilization: A cohort study in Romania

Exp Ther Med. 2022 Jan;23(1):34. doi: 10.3892/etm.2021.10956. Epub 2021 Nov 9.

Authors

Andreea Mădălina Bănică^{1

2}, Simona Daniela Popescu^{1

2}, Simona Vlădăreanu^{1

2}

Affiliations

¹ Department 13 - Obstetrics-Gynecology, Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.
² Department of Neonatology, 'Elias' University Emergency Hospital, 011461 Bucharest, Romania.

Abstract

Although in recent years the number of pregnancies obtained through in vitro fertilization (IVF) has increased significantly, a higher incidence of complications has been identified in this group. The widespread development and use of IVF has led to an increasing rate of multiple pregnancies and thus their associated complications. However, whether these complications occur due to assisted reproduction or infertility problems remains to be elucidated. In the present study, a comparison was made of IVF pregnancies with spontaneous conception, and the risk of obstetric and neonatal complications was assessed. An ambispective observational cohort study was carried out between January 2017 and October 2021 at Elias University Emergency Hospital, Romania. The exposed cohort included 132 IVF pregnancies and the control cohort included 157 spontaneous pregnancies. The IVF group included 110 pregnancies with fresh embryo-transfer and 22 pregnancies with cryopreserved embryo-transfer. Obstetric, perinatal and neonatal complications were analysed by multivariable logistic analysis. The results showed that, IVF pregnancies had a higher risk of pregnancy-induced hypertension (OR=6.42, 95% CI=1.72-23.92) and placental abnormalities (OR=5.49, 95% CI=1.07-28.17). Neonates obtained through IVF had a higher risk of prematurity (OR=6.52, 95% CI=2.99-14.20), low birth weight (LBW) (OR=17.18, 95% CI=7.06-41.87), small for gestational age (OR=4.10, 95% CI=1.95-8.59) and were more frequently hospitalized in the Neonatal Intensive Care Unit (NICU) (OR=11.91, 95% CI=5.72-24.81). Nulliparous women were associated with an increased risk of NICU admission (OR=0.46, 95% CI=0.25-0.88) and risk of LBW (OR=0.37, 95% CI=0.19-0.75). Maternal age ≥35 years had no influence as a confounding variable. In conclusion, this cohort study showed that IVF pregnancies have a higher risk of obstetric and neonatal complications than pregnancies obtained by spontaneous conception.

Keywords: elective single embryo-transfer; in vitro fertilization; multiple pregnancies; neonatal complications; obstetric complications.

Grants and funding

Funding: No funding was received.