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Published in: Journal of Assisted Reproduction and Genetics 12/2019

01-12-2019 | In Vitro Fertilisation | Assisted Reproduction Technologies

Obstetric and perinatal complications associated with assisted reproductive treatment in Spain

Authors: Ana Ballesta-Castillejos, Juan Gomez-Salgado, Julian Rodriguez-Almagro, Inmaculada Ortiz-Esquinas, Antonio Hernández-Martínez

Published in: Journal of Assisted Reproduction and Genetics | Issue 12/2019

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Abstract

Background

Although most newborns conceived through assisted reproductive treatments are healthy, there are concerns about the safety of reproductive techniques and their effect on foetal/maternal well-being.

Objective

This study aims to describe the incidence of obstetric and perinatal complications in women undergoing assisted reproductive treatments in the Spanish Health System.

Method

This is a cross-sectional observational study aimed at women who have been mothers between 2013 and 2018 in Spain. The data was collected through an online survey of 42 items that was distributed through lactation associations and postpartum support groups. In the data analysis, crude odds ratios (OR) and adjusted odds ratios (AOR) were calculated, through a multivariate analysis with binary logistic regression and multinomial logistic regression.

Results

Five thousand nine hundred forty-two women participated, 2.3% (139) through artificial insemination and 8.2% (486) through in vitro fertilisation (IVF) techniques. Women who underwent IVF had a higher likelihood of suffering problems during pregnancy (OR = 1.71; 95% confidence intervals (95% CI), 1.37–2.13), delivery (OR = 1.43; 95% CI, 1.01–2.02), and postpartum (OR = 1.94; 95% CI, 1.40–2.69) than women with spontaneous pregnancy. No increased likelihood of neonatal problems was observed in this group except for twin pregnancy (OR = 9.17; 95% CI, 6.02–13.96) and prematurity (OR = 1.43; 95% CI, 1.01–2.02). No differences were observed between spontaneous pregnancies and those achieved by artificial insemination.

Conclusions

Pregnancies achieved through IVF present a higher risk of complications before, during and after delivery. However, there is no increased risk of neonatal problems except for a higher likelihood of twin pregnancy and prematurity.
Literature
1.
go back to reference Quinn CO. Exclusive breastfeeding and assisted reproductive technologies: a Calgary cohort. Reprod Syst Sex Disord. 2012;s5. Quinn CO. Exclusive breastfeeding and assisted reproductive technologies: a Calgary cohort. Reprod Syst Sex Disord. 2012;s5.
2.
go back to reference Nygren K, Lazdane G. Current trends of fertility—and infertility—in Europe. Entre Nous. The European Magazine for sexual and reproductive health low-fertility—the future of Europe? 2006;10–2. Nygren K, Lazdane G. Current trends of fertility—and infertility—in Europe. Entre Nous. The European Magazine for sexual and reproductive health low-fertility—the future of Europe? 2006;10–2.
3.
go back to reference Chambers GM, Adamson GD, Eijkemans MJC. Acceptable cost for the patient and society. Fertil Steril. 2013;100(2):319–27.CrossRef Chambers GM, Adamson GD, Eijkemans MJC. Acceptable cost for the patient and society. Fertil Steril. 2013;100(2):319–27.CrossRef
4.
go back to reference Cavoretto P, Candiani M, Giorgione V, Inversetti A, Abu-Saba MM, Tiberio F, et al. Risk of spontaneous preterm birth in singleton pregnancies conceived after IVF/ICSI treatment: meta-analysis of cohort studies. Ultrasound Obstet Gynecol. 2018;51(1):43–53.CrossRef Cavoretto P, Candiani M, Giorgione V, Inversetti A, Abu-Saba MM, Tiberio F, et al. Risk of spontaneous preterm birth in singleton pregnancies conceived after IVF/ICSI treatment: meta-analysis of cohort studies. Ultrasound Obstet Gynecol. 2018;51(1):43–53.CrossRef
5.
go back to reference Zollner U, Dietl J. Perinatal risks after IVF and ICSI. J Perinat Med. 2013;41(1):17–22.CrossRef Zollner U, Dietl J. Perinatal risks after IVF and ICSI. J Perinat Med. 2013;41(1):17–22.CrossRef
6.
go back to reference Kouhkan A, Khamseh ME, Pirjani R, Moini A, Arabipoor A, Maroufizadeh S, et al. Obstetric and perinatal outcomes of singleton pregnancies conceived via assisted reproductive technology complicated by gestational diabetes mellitus: a prospective cohort study. BMC Pregnancy Childbirth. 2018;18. Kouhkan A, Khamseh ME, Pirjani R, Moini A, Arabipoor A, Maroufizadeh S, et al. Obstetric and perinatal outcomes of singleton pregnancies conceived via assisted reproductive technology complicated by gestational diabetes mellitus: a prospective cohort study. BMC Pregnancy Childbirth. 2018;18.
7.
go back to reference Ricciarelli E, Bruna I, Verdú V, Torrelló MJ, Herrer R, Gris JM, et al. Impact of assisted reproduction treatments on Spanish newborns: report of 14,119 pregnancies. J Assist Reprod Genet. 2013;30(7):897–905.CrossRef Ricciarelli E, Bruna I, Verdú V, Torrelló MJ, Herrer R, Gris JM, et al. Impact of assisted reproduction treatments on Spanish newborns: report of 14,119 pregnancies. J Assist Reprod Genet. 2013;30(7):897–905.CrossRef
8.
go back to reference Luke B, Brown MB, Wantman E, Seifer DB, Sparks AT, Lin PC, et al. Risk of prematurity and infant morbidity and mortality by maternal fertility status and plurality. J Assist Reprod Genet. 2019;36(1):121–38.CrossRef Luke B, Brown MB, Wantman E, Seifer DB, Sparks AT, Lin PC, et al. Risk of prematurity and infant morbidity and mortality by maternal fertility status and plurality. J Assist Reprod Genet. 2019;36(1):121–38.CrossRef
11.
go back to reference Zhu L, Zhang Y, Liu Y, Zhang R, Wu Y, Huang Y, et al. Maternal and live-birth outcomes of pregnancies following assisted reproductive technology: a retrospective cohort study. Sci Rep. 2016;6. Zhu L, Zhang Y, Liu Y, Zhang R, Wu Y, Huang Y, et al. Maternal and live-birth outcomes of pregnancies following assisted reproductive technology: a retrospective cohort study. Sci Rep. 2016;6.
12.
go back to reference Ashrafi M, Gosili R, Hosseini R, Arabipoor A, Ahmadi J, Chehrazi M. Risk of gestational diabetes mellitus in patients undergoing assisted reproductive techniques. Eur J Obstet Gynecol Reprod Biol. 2014;176:149–52.CrossRef Ashrafi M, Gosili R, Hosseini R, Arabipoor A, Ahmadi J, Chehrazi M. Risk of gestational diabetes mellitus in patients undergoing assisted reproductive techniques. Eur J Obstet Gynecol Reprod Biol. 2014;176:149–52.CrossRef
13.
go back to reference Zádori J, Kozinszky Z, Orvos H, Katona M, Pál A, Kovács L. Dilemma of increased obstetric risk in pregnancies following IVF-ET. J Assist Reprod Genet. 2003;20(6):216–21.CrossRef Zádori J, Kozinszky Z, Orvos H, Katona M, Pál A, Kovács L. Dilemma of increased obstetric risk in pregnancies following IVF-ET. J Assist Reprod Genet. 2003;20(6):216–21.CrossRef
14.
go back to reference Luke B, Brown MB, Wantman E, Seifer DB, Sparks AT, Lin PC, et al. Risk of prematurity and infant morbidity and mortality by maternal fertility status and plurality. J Assist Reprod Genet. 2019;36(1):121–38.CrossRef Luke B, Brown MB, Wantman E, Seifer DB, Sparks AT, Lin PC, et al. Risk of prematurity and infant morbidity and mortality by maternal fertility status and plurality. J Assist Reprod Genet. 2019;36(1):121–38.CrossRef
15.
go back to reference Wang YA, Sullivan EA, Healy DL, Black DA. Perinatal outcomes after assisted reproductive technology treatment in Australia and New Zealand: single versus double embryo transfer. Med J Aust. 2009;190(5):234–7.CrossRef Wang YA, Sullivan EA, Healy DL, Black DA. Perinatal outcomes after assisted reproductive technology treatment in Australia and New Zealand: single versus double embryo transfer. Med J Aust. 2009;190(5):234–7.CrossRef
16.
go back to reference Sullivan-Pyke CS, Senapati S, Mainigi MA, Barnhart KT. In vitro fertilization and adverse obstetric and perinatal outcomes. Semin Perinatol. 2017;41(6):345–53.CrossRef Sullivan-Pyke CS, Senapati S, Mainigi MA, Barnhart KT. In vitro fertilization and adverse obstetric and perinatal outcomes. Semin Perinatol. 2017;41(6):345–53.CrossRef
17.
go back to reference Sunderam S, Kissin DM, Crawford SB, Folger SG, Boulet SL, Warner L, et al. Assisted reproductive technology surveillance—United States, 2015. MMWR Surveill Summ 2018;67(3):1–28.CrossRef Sunderam S, Kissin DM, Crawford SB, Folger SG, Boulet SL, Warner L, et al. Assisted reproductive technology surveillance—United States, 2015. MMWR Surveill Summ 2018;67(3):1–28.CrossRef
18.
go back to reference De Geyter C, Calhaz-Jorge C, Kupka MS, Wyns C, Mocanu E, Motrenko T, et al. ART in Europe, 2014: results generated from European registries by ESHRE†. Hum Reprod. 2018;33(9):1586–601.CrossRef De Geyter C, Calhaz-Jorge C, Kupka MS, Wyns C, Mocanu E, Motrenko T, et al. ART in Europe, 2014: results generated from European registries by ESHRE†. Hum Reprod. 2018;33(9):1586–601.CrossRef
19.
go back to reference Seggers J, Pontesilli M, Ravelli ACJ, Painter RC, Hadders-Algra M, Heineman MJ, et al. Effects of in vitro fertilization and maternal characteristics on perinatal outcomes: a population-based study using siblings. Fertil Steril. 2016;105(3):590–598.e2.CrossRef Seggers J, Pontesilli M, Ravelli ACJ, Painter RC, Hadders-Algra M, Heineman MJ, et al. Effects of in vitro fertilization and maternal characteristics on perinatal outcomes: a population-based study using siblings. Fertil Steril. 2016;105(3):590–598.e2.CrossRef
20.
go back to reference Peduzzi P, Concato J, Kemper E, Holford TR, Feinstein AR. A simulation study of the number of events per variable in logistic regression analysis. J Clin Epidemiol. 1996;49(12):1373–9.CrossRef Peduzzi P, Concato J, Kemper E, Holford TR, Feinstein AR. A simulation study of the number of events per variable in logistic regression analysis. J Clin Epidemiol. 1996;49(12):1373–9.CrossRef
21.
go back to reference Hamilton BE, Martin JA, Osterman MJK, Curtin SC, Matthews TJ. Births: final data for 2014. Natl Vital Stat Rep. 2015;64(12):1–64.PubMed Hamilton BE, Martin JA, Osterman MJK, Curtin SC, Matthews TJ. Births: final data for 2014. Natl Vital Stat Rep. 2015;64(12):1–64.PubMed
22.
go back to reference Chen X-K, Wen SW, Bottomley J, Smith GN, Leader A, Walker MC. In vitro fertilization is associated with an increased risk for preeclampsia. Hypertens Pregnancy. 2009;28(1):1–12.CrossRef Chen X-K, Wen SW, Bottomley J, Smith GN, Leader A, Walker MC. In vitro fertilization is associated with an increased risk for preeclampsia. Hypertens Pregnancy. 2009;28(1):1–12.CrossRef
23.
go back to reference Jackson RA, Gibson KA, Wu YW, Croughan MS. Perinatal outcomes in singletons following in vitro fertilization: a meta-analysis. Obstet Gynecol. 2004;103(3):551–63.CrossRef Jackson RA, Gibson KA, Wu YW, Croughan MS. Perinatal outcomes in singletons following in vitro fertilization: a meta-analysis. Obstet Gynecol. 2004;103(3):551–63.CrossRef
24.
go back to reference Shevell T, Malone FD, Vidaver J, Porter TF, Luthy DA, Comstock CH, et al. Assisted reproductive technology and pregnancy outcome. Obstet Gynecol. 2005;106(5 Pt 1):1039–45.CrossRef Shevell T, Malone FD, Vidaver J, Porter TF, Luthy DA, Comstock CH, et al. Assisted reproductive technology and pregnancy outcome. Obstet Gynecol. 2005;106(5 Pt 1):1039–45.CrossRef
25.
go back to reference Reddy UM, Wapner RJ, Rebar RW, Tasca RJ. Infertility, assisted reproductive technology, and adverse pregnancy outcomes: executive summary of a National Institute of Child Health and Human Development workshop. Obstet Gynecol. 2007;109(4):967–77.CrossRef Reddy UM, Wapner RJ, Rebar RW, Tasca RJ. Infertility, assisted reproductive technology, and adverse pregnancy outcomes: executive summary of a National Institute of Child Health and Human Development workshop. Obstet Gynecol. 2007;109(4):967–77.CrossRef
26.
go back to reference Allen VM, Wilson RD, Cheung A. Pregnancy outcomes after assisted reproductive technology. J Obstet Gynaecol Can. 2006;28(3):220–33.CrossRef Allen VM, Wilson RD, Cheung A. Pregnancy outcomes after assisted reproductive technology. J Obstet Gynaecol Can. 2006;28(3):220–33.CrossRef
27.
go back to reference Calina D, Docea AO, Golokhvast KS, Sifakis S, Tsatsakis A, Makrigiannakis A. Management of endocrinopathies in pregnancy: a review of current evidence. Int J Environ Res Public Health. 2019;16(5):781.CrossRef Calina D, Docea AO, Golokhvast KS, Sifakis S, Tsatsakis A, Makrigiannakis A. Management of endocrinopathies in pregnancy: a review of current evidence. Int J Environ Res Public Health. 2019;16(5):781.CrossRef
28.
go back to reference Insua MF, Cobo AC, Larreategui Z, Ferrando M, Serra V, Meseguer M. Obstetric and perinatal outcomes of pregnancies conceived with embryos cultured in a time-lapse monitoring system. Fertil Steril. 2017;108(3):498–504.CrossRef Insua MF, Cobo AC, Larreategui Z, Ferrando M, Serra V, Meseguer M. Obstetric and perinatal outcomes of pregnancies conceived with embryos cultured in a time-lapse monitoring system. Fertil Steril. 2017;108(3):498–504.CrossRef
Metadata
Title
Obstetric and perinatal complications associated with assisted reproductive treatment in Spain
Authors
Ana Ballesta-Castillejos
Juan Gomez-Salgado
Julian Rodriguez-Almagro
Inmaculada Ortiz-Esquinas
Antonio Hernández-Martínez
Publication date
01-12-2019
Publisher
Springer US
Published in
Journal of Assisted Reproduction and Genetics / Issue 12/2019
Print ISSN: 1058-0468
Electronic ISSN: 1573-7330
DOI
https://doi.org/10.1007/s10815-019-01631-6

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