Pregnancy after in vitro fertilization: obstetric and perinatal risks

Relevance: The incidence of infertile marriages in Russia is steadily increasing, as is the rate of pregnancies after assisted reproductive technologies (ART). However, obstetric and perinatal outcomes of patients undergoing ART have not been fully studied.

Objective: To evaluate the incidence and structure of obstetric and perinatal complications in pregnant women following in vitro fertilization (IVF).

Materials and methods: Obstetric and perinatal outcomes were retrospectively analyzed in 96 patients with singleton pregnancies resulting from IVF (study group) and in 96 patients with spontaneous pregnancy (control group), who were matched by age, parity, and other characteristics.

Results: The incidence of major pregnancy complications in the control group was not significantly different from that in the study group. However, the study group had a significantly higher incidence of anemia (54/96 (56.3%) vs. 24/96 (25.0%); p<0.001) and gestational diabetes mellitus (26/96 (27.1%) vs. 11/96 (11.5%); p=0.01), as well as uteroplacental blood flow abnormalities in the third trimester of pregnancy and before delivery (40/96 (41.7%) vs. 25/96 (26.0%); p=0.03). The majority of patients in the study group underwent cesarean section (71/96 (74.0%) vs. 25/96 (26.0%), respectively; p<0.001). In study group planned surgeries were more common than emergency surgeries (60/71 (84.5%) vs. 9/25 (36.0%), respectively; p<0.001). Opposite dynamics were observed in the control group. Newborns from mothers in the study group were eight times more likely to have septal heart defects (15/96 (15.6%) versus 2/96 (2.1%); p>0.05) and were six times more likely to have transient hypoglycemia (19/96 (19.8%) vs. 3/96 (3.1%); p>0.05). They were also 2 times more likely to require a second stage of nursing (7/96 (7.3%) vs. 3/96 (3.1%); p>0.05).

Conclusion: The identified features of the course of pregnancy and the condition of newborns in patients who became pregnant as a result of IVF indicate that pregnancy in this group of patients should be managed by highly qualified obstetrician-gynecologists. When planning childbirth, it is necessary to assess the risks and choose the optimal method of delivery and a maternity facility where there is a possibility of early neonatal diagnosis of congenital malformations and provision of prolonged postnatal care to newborns.