scholarly journals Maternal characteristics and pregnancy outcomes among Chinese women with infertility undergoing assisted reproductive technology: a retrospective cohort study

2019 ◽  
Author(s):  
jingxue wang ◽  
qiwei liu ◽  
Boer Deng ◽  
fang chen ◽  
xiaowei liu ◽  
...  

Abstract Background: To examine differences in maternal characteristics and pregnancy outcomes among Chinese women with infertility due to various reasons who underwent assisted reproductive technology(ART). Methods: This retrospective cohort study included women who used ART for various reasons. Demographics, medical history, laboratory tests, and delivery data were reviewed. Results: The ART treatment group was divided into 5 subgroups according to reason for infertility: ovulation disorder, tubal disease, male factor, endometriosis, multiple infertility-related diagnoses. Compared with spontaneous pregnancies, significant increases in the following were observed with ART: rates of gestational diabetes mellitus(GDM), preeclampsia, preterm premature rupture of membranes, postpartum hemorrhage, and chorioamnionitis in ovulation disorder; GDM, placenta previa and postpartum hemorrhage in tubal disease; placenta previa in endometriosis and male factor; and GDM, placenta previa and chorioamnionitis in multiple infertility-related diagnoses. Preterm birth, low birthweight, and small for gestational age were increased in all ART groups. Macrosomia and neonatal intensive care unit admission were increased in maternal factors with ART. Conclusions: During the perinatal period, women with different reasons for undergoing ART have different maternal characteristics and infant outcomes when compared with women not using ART, perinatal morbidities are higher in women undergoing ART for most reasons. The worst and best prognoses for infertility were found for that caused by ovulation disorder and male factor, respectively.

2020 ◽  
Author(s):  
jingxue wang ◽  
qiwei liu ◽  
Boer Deng ◽  
fang chen ◽  
xiaowei liu ◽  
...  

Abstract Background: To examine differences in the maternal characteristics and pregnancy outcomes of Chinese women with various causes of infertility who underwent in vitro fertilization (IVF) with embryonic cryopreservation treatment.Methods: Cases were pregnancies after IVF-ET with embryonic cryopreservation; controls were spontaneously conceived pregnancies. Subgroup analysis was carried out according to etiology of infertility. The IVF treatment group was divided into 5 subgroups according to infertility etiology as follows: ovulation disorder, tubal disease, male infertility, endometriosis, and mixed infertility. Data on demographic characteristics, medical history, laboratory tests, and delivery were reviewed. Logistic regression analysis was performed for pregnancy and perinatal complications and neonatal outcomes. The multivariable model was adjusted for potential confounders.Results: Among singleton pregnancies, compared with spontaneous pregnancies, IVF pregnancies were associated with significant increases in the rates of the following: gestational diabetes mellitus (GDM) (aOR 1.76[95% CI 1.33-2.33]), preeclampsia (2.60[1.61-4.20]), preterm preeclampsia (4.52[2.03-10.06]), postpartum hemorrhage (1.57[1.04-2.36]), intrahepatic cholestasis of pregnancy (3.84[1.06-13.94]), preterm premature rupture of membranes (2.11[1.17-3.81]), preterm birth (1.95[CI 1.26-3.01]), low birthweight (1.90[1.13-3.20]), macrosomia (1.53[1.03-2.27]), and neonatal intensive care unit (NICU) admission (1.69[1.22-2.34]) in the ovulation disorder group; GDM (1.50[1.21-1.86]), placenta previa (2.70[1.59-4.59]), placenta accreta (1.78[1.10-2.89]), postpartum hemorrhage (1.61[1.19-2.18]), macrosomia (1.60[1.21-2.13]) and 5-minute Apgar score ≤7 (4.09[1.04-16.08]) in the tubal disease group; placenta previa (9.33[4.22-20.62]), small for gestational age (2.29[1.04-5.08]), macrosomia (2.00[1.02-3.95]) and NICU admission (2.35[1.35-4.09]) in the endometriosis group; placenta previa (4.14[2.23-7.68]) and placenta accreta (2.05[1.08-3.87]) in the male infertility group; and GDM (1.85[1.15-2.98]), placenta previa (4.73[1.83-12.21]), placental abruption (3.39[1.20-9.56]), chorioamnionitis (2.93[1.04-8.26]), preterm birth (2.69[1.41-5.15]), and 1-minute Apgar score ≤7 (4.68[1.62-13.51]) in the mixed infertility group. Among multiple pregnancies, most of the differences that were significant in singleton pregnancies were less extensive or had disappeared.Conclusions: Infertility etiology within the IVF population was found to affect maternal and neonatal outcomes among all births. During the perinatal period, infertility etiology appears to be an additional risk factor for abnormal pregnancy outcomes besides the use of IVF techniques compared with spontaneous pregnancies. Higher risk was found for ovulation disorders, and lower risk was found for male infertility.


2020 ◽  
Author(s):  
Jingxue Wang(Former Corresponding Author) ◽  
Qiwei Liu ◽  
Boer Deng ◽  
Fang Chen ◽  
Xiaowei Liu ◽  
...  

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.


2020 ◽  
Author(s):  
jingxue wang ◽  
qiwei liu ◽  
Boer Deng ◽  
fang chen ◽  
xiaowei liu ◽  
...  

Abstract Background: To examine differences in the maternal characteristics and pregnancy outcomes of Chinese women with various causes of infertility who underwent in vitro fertilization(IVF) with embryonic cryopreservation treatment.Methods: This retrospective cohort study included women with various causes of infertility who used IVF. In order to reduce the research error, we deliberately removed the fresh ET cycles and ICSI cycles at the beginning, so in our data the IVF-ET method was frozen-embryo transfer.[MOU1] [MOU2] 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.[MOU3] Results: The IVF 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, we verified that IVF with embryonic cryopreservation pregnancies are related to increased risks of adverse perinatal outcomes. Besides,compared with spontaneous pregnancies, IVF 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, small for gestational age, macrosomia and NICU admission in the endometriosis group; placenta previa and placenta accreta in the male infertility group; and GDM, placenta previa, placental abruption, chorioamnionitis, preterm birth, and 1-minute Apgar score≤7 in the mixed infertility group. Among multiple pregnancies, most of the differences that were significant in singleton pregnancies were less extensive or had disappeared.[MOU4] [MOU5] 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.[MOU6]


PLoS ONE ◽  
2015 ◽  
Vol 10 (3) ◽  
pp. e0116231 ◽  
Author(s):  
Charles S. Cornford ◽  
Helen J. Close ◽  
Roz Bray ◽  
Deborah Beere ◽  
James M. Mason

2019 ◽  
Vol 489 ◽  
pp. 130-135 ◽  
Author(s):  
Xiaosong Yuan ◽  
Wei Long ◽  
Jianbing Liu ◽  
Bin Zhang ◽  
Wenbai Zhou ◽  
...  

2021 ◽  
Author(s):  
Guifang Deng ◽  
Lanlan Wu ◽  
Yao Liu ◽  
Zengyou Liu ◽  
Hengying Chen ◽  
...  

Abstract Background: Blood urea nitrogen (BUN) and creatinine (SCr) are associated with gestational diabetes mellitus (GDM). However, there were limited data in the literature on the influence of BUN and SCr on maternal and fetal outcomes of pregnancy. We aimed to examine the association of BUN and SCr levels during gestation with the risk of selected adverse pregnancy outcomes.Methods: This retrospective cohort study included 1606 singleton mothers aged 22-44 years. Both BUN and SCr levels were collected and measured during the second (16-18th week), third (28-30th week) trimesters of gestation respectively and followed up pregnancy outcomes. Statistical analysis was used multivariate logistic regression. Results: In the multivariate adjusted logistic regression model, the highest level of SCr in the second trimester increased the risk of PROM by 45% (95% CI, 1.01-2.09). In the third trimester of gestation, compared with those in the lowest quartile, BUN levels in the highest quartile decreased the risk of macrosomia and LGA by 60%(95% CI, 0.20-0.78), 66%(95% CI, 0.21,0.55) , respectively, and increased the risk of SGA by 137%(1.06, 5.31), 186%(1.29,6.34) in the third and fourth quartiles, respectively. The adjusted OR (95%CI) for macrosomia in the fourth quartile was 0.46 (0.24, 0.87), for SGA in the third quartiles was 2.36 (1.10, 5.10), and for LGA in the fourth quartile was 0.61 (0.41,0.91) compared with those in the first quartile of SCr levels. The elevated changes of BUN (> 0.64mmol/L) was the risk factor of SGA (OR: 2.11, 95%CI: 1.03,4.32).Conclusion: Higher BUN and SCr levels during the 28-30th week of gestation even those towards the upper limit of the normal range can act as a warning sign of the impending SGA. Elevated changes of BUN and SCr during pregnancy also associated with the lower birth weight.


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