Maternal characteristics and pregnancy outcomes of Chinese women with infertility undergoing assisted reproductive technology treatment:a retrospective cohort study

Abstract

Background : To examine differences in the maternal characteristics and pregnancy outcomes of Chinese women with various causes of infertility who underwent assisted reproductive technology (ART) treatment. Methods: This retrospective cohort study included women with various causes of infertility who used ART. Data on demographic characteristics, medical history, laboratory tests, and delivery were reviewed. Logistic regression analysis was performed to calculate odds ratios and 95% confidence intervals for pregnancy and perinatal complications and neonatal outcomes. The multivariable model was adjusted for age, gravidity, parity, pre-pregnancy obesity, birth plurality , and history of previous caesarean section. Results: The ART treatment group was divided into 5 subgroups according to infertility cause as follows: ovulation disorder, tubal disease, male infertility , endometriosis, and mixed infertility . Among singleton pregnancies, compared with spontaneous pregnancies , ART pregnancies were associated with significant increases in the rates of the following: gestational diabetes mellitus (GDM), preeclampsia, preterm preeclampsia, postpartum haemorrhage , intrahepatic cholestasis of pregnancy , preterm premature rupture of membranes, preterm birth, low birthweight, macrosomia, and neonatal intensive care unit (NICU) admission in the ovulation disorder group; GDM, placenta previa, placenta accreta , postpartum haemorrhage, macrosomia and 5 -minute Apgar score ≤7 in the tubal disease group; placenta previa, a bnormal placental cord insertion , small for gestational age, macrosomia and NICU admission in the endometriosis group; placenta previa and placenta accreta i n the male infertility group; and GDM, placenta previa, placental abruption, chorioamnionitis, preterm birth , and 1-minute Apgar score≤7 i n the mixed infertility group. Among multiple pregnancies, most of the differences that were significant in singleton pregnancies were less extensive or had disappeared. Conclusions: During the perinatal period, maternal characteristics, in particular type of infertility, appears an additional risk factor for abnormal pregnancy outcomes besides use of IVF techniques. Lower risk is found in male infertility and higher risk for ovulation disorders.