Evaluation of Maternal and Neonatal Outcomes of Assisted Reproduction Technology: A Retrospective Cohort Study

Abstract

Background: To evaluate maternal and neonatal outcomes of assisted reproductive technology (ART). Materials and Methods: Pregnant women registered from 2015 through 2017 (n = 6994) at five perinatal centers that managed high-risk pregnancies in Mie, Japan, retrospectively. Rates of preterm birth (<37 gestational weeks), early onset preeclampsia (<34 gestational weeks), late onset preeclampsia (≥34 gestational weeks), low-lying placenta, placenta previa, placenta accreta, placental abruption, atonic bleeding, uterine rupture, and amniotic fluid embolism after ART were evaluated. ART was defined as in vitro fertilization and micro-fertilization. Fisher’s exact test, Mann–Whitney’s U test, and logistic regression analysis were used to analyze the data. Results: Rates of obstetrical complications including low-lying placenta, placenta previa, placenta accreta, and atonic bleeding were increased with ART compared to those with the control. Particularly, ART was associated with a significantly increased rate of placenta accreta (adjusted odds ratio: 7.35, 95% confidence interval (CI): 3.20–16.6) and significantly decreased rate of placental abruption (adjusted odds ratio: 0.24, 95% CI: 0.07–0.61). Conclusions: This study showed that ART may reduce placental abruption and increase placenta previa. There is a possibility that the placenta attaches deeper in the myometrium because of ART.

Placenta Accreta Spectrum Disorder Complicated with Endometriosis: Systematic Review and Meta-Analysis

“…Four studies were excluded due to the presence of overlapping cases [ 39 , 40 , 41 , 42 ]. Forty-eight studies that comprised 34,603,164 pregnancies and 59,241 pregnancies with endometriosis met the inclusion criteria for the descriptive analysis [ 26 , 27 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 ,…”

“…Supplemental Tables S1–S4 summarizes the metadata of the 48 included studies [ 26 , 27 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 ] and 4 excluded studies [ 39 , 40 ,…”

“…Fourteen of 48 studies were nationwide studies, and no study was a randomized, controlled study. Approximately one-third of the studies were performed in Europe ( n = 17; 35.4%) [ 27 , 46 , 48 , 53 , 54 , 57 , 60 , 62 , 64 , 70 , 71 , 72 , 73 , 77 , 79 , 83 , 86 ], followed by Japan ( n = 11; 22.9%) [ 26 , 52 , 55 , 56 , 58 , 59 , 68 , 74 , 81 , 82 , 88 ], China ( n = 10; 20.8%) [ 43 , 45 , 47 , 49 , 61 , 66 , 67 , 69 , 78 , 80 ], the United States ( n = 4; 8.3%) [ 50 , 51 , 75 , 87 ], Israel ( n = 2; 4.2%) [ 63 , 84 ], Australia ( n = 2; 4.2%) [ 76 , 85 ], Canada ( n = 1; 2.1%) [ …”

“…A meta-analysis using 27 comparative retrospective studies (7 of low and 20 of moderate quality) was conducted to determine the influence of ART on the prevalence of placenta previa ( Supplemental Table S2 , Table 3 ) [ 26 , 43 , 47 , 48 , 49 , 51 , 52 , 53 , 54 , 55 , 57 , 60 , 61 , 62 , 65 , 66 , 67 , 69 , 72 , 73 , 78 , 79 , 82 , 85 , 86 , 87 , 88 ]. Since considerable heterogeneity of studies was observed, a random-effects analysis was used.…”

Predictors of Cognitive Defects and Its Prevention Capabilities in Premature Infants

“…более 97% новорожденных). Повышенную частоту недонашивания при использовании ВРТ связывают с особенностями имплантации эмбриона и расположением плаценты -более часто отмечается ее предлежание, хотя в то же время отслойка плаценты происходит реже в связи с более глубоким врастанием хориона в миометрий после применения ВРТ [20].…”