Comparison of neonatal outcomes of very low birth weight infants by mode of conception: in vitro fertilization versus natural pregnancy

Heo, Ju Sun; Lee, Hee Jun; Lee, Myung hee; Choi, Chang Won

doi:10.1016/j.fertnstert.2019.01.014

Cited by 17 publications

(18 citation statements)

References 33 publications

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“…Th erefore, this increase has been attributed to infertility itself and underlaying factors associated to infertility rather than ART [19,33]. In accordance with our results, Heo et al [6] demonstrated that the incidence of major congenital anomalies in infants born as singletons aft er IVF was not higher than that in those born aft er NP aft er adjusting for confounding factors. As pointed out by the authors and in accordance with our recent results, the more generalized use of preimplantation genetic screening procedures may contribute to a lower incidence of congenital anomalies aft er ART procedures [35,36].…”

Section: One Of the Sources Of Perinatal Complications (Especiallysupporting

confidence: 89%

“…Over the course of the last decades, a substantial number of children have been conceived aft er applying assisted reproductive technology (ART) procedures [1,2]. It has been generally assumed that pregnancies achieved aft er ART have a higher prevalence of obstetric and perinatal complications such as prematurity and low birthweight neonates and a higher prevalence of cesarean sections at delivery [3][4][5][6][7]. Such perinatal complications could be a direct consequence of the higher rate of multiple pregnancies.…”

Section: Introductionmentioning

confidence: 99%

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Obstetrical and Perinatal Complications after Assisted Reproduction: what matters is age, not the procedure

Barrenetxea¹

2020

RIJOG

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Background: Worldwide, an increasing number of children (1 out of 10 in some countries) are born to pregnancies achieved by applying assisted reproductive technology (ART). It has been assumed that these pregnancies have a higher prevalence of both obstetric and neonatal complications compared to gestations achieved after natural reproduction (NR). Objective: The purpose of this study was to evaluate and compare maternal obstetrical and perinatal complications between pregnancies achieved after ART and NP, in a setting in which a strict policy of single embryo transfer is followed. Study design: This is an observational comparative study to assess obstetrical and perinatal outcomes involving 583 patients who achieved an ongoing pregnancy after ART, by using either autologous (AO) (363 women) or donated oocytes (DO) (220 women) at a University associated Assisted Reproduction Center, between January, 2016 and December, 2018. Age of women at delivery, gestational length, type of delivery, birthweight of newborns and perinatal complications were registered and compared to 273 deliveries of pregnant women after NP clinically followed at our center. Results: Due to strict single embryo transfer policy the rate of multiple pregnancies after ART (1,38%) was comparable to that of gestations after NR (1,10%) (OR: 1,25; 95% CI 0,33-4,76). In our series, the percentage of women aged 35 or older (AMA) and 40 and older (VAMA), was similar between women in the NR group (59,34% and 17,22%) and those of the ART with autologous oocytes (AO) group (57,85% and 13,77%) (p=0,759 and p=0,234). Age of women was signi icantly higher in women pregnant after ART-DO procedures. The rate of preterm deliveries was 6,59%, 3,58% and 12,27% for NR, ART-AO and ART-DO respectively. Birthweight of neonates after ART-AO was signi icantly higher than after NR (p=0,000) and after ART-DO (p=0,000).

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Section: One Of the Sources Of Perinatal Complications (Especiallysupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Obstetrical and Perinatal Complications after Assisted Reproduction: what matters is age, not the procedure

Barrenetxea¹

2020

RIJOG

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“…Epidemiological studies have demonstrated that even singleton pregnancies conceived after IVF-ET are more likely to develop prematurity, gestational hypertension, placental abruption, low birth weight and intrauterine growth retardation [6][7][8][9][10]. The risk of adverse outcomes originating from suboptimal placentation in pregnancies after IVF-ET is significantly greater than that in spontaneously conceived pregnancies [33,34].…”

Section: Discussionmentioning

confidence: 99%

“…This positive trend is due to more appropriate embryo transfer strategies, milder ovarian stimulation, laboratory technological advances, and improved culture media [5]. However, even in singleton pregnancy, after adjustment for maternal confounding factors, the risk of multiple adverse outcomes during the perinatal period, including miscarriage, preterm birth, small for gestational age, low birth weight and gestational hypertension, are higher in IVF-ET pregnancies than in spontaneously conceived pregnancies [6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

The placental transcriptome of the first-trimester placenta is affected by in vitro fertilization and embryo transfer

Zhao¹,

Zheng²,

Liu³

et al. 2019

Reprod Biol Endocrinol

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Background: The placenta is a highly specialized temporary organ that is related to fetal development and pregnancy outcomes, and epidemiological data demonstrate an increased risk of placental abnormality after in vitro fertilization and embryo transfer (IVF-ET). Methods: This study examines alterations in the transcriptome profile of first-trimester placentas from IVF-ET pregnancies and analyzes the potential mechanisms that play a role in the adverse perinatal outcomes associated with IVF-ET procedures. Four human placental villi from first-trimester samples were obtained through fetal bud aspiration from patients subjected to IVF-ET due to oviductal factors. An additional four control human placental villi were derived from a group of subjects who spontaneously conceived a twin pregnancy. We analyzed their transcriptomes by microarray. Then, RT-qPCR and immunohistochemistry were utilized to analyze several dysregulated genes to validate the microarray results. Biological functions and pathways were analyzed with bioinformatics tools. Results: A total of 3405 differentially regulated genes were identified as significantly dysregulated (> 2-fold change; P < 0.05) in the IVF-ET placenta in the first trimester: 1910 upregulated and 1495 downregulated genes. Functional enrichment analysis of the differentially regulated genes demonstrated that the genes were involved in more than 50 biological processes and pathways that have been shown to play important roles in the first trimester in vivo. These pathways can be clustered into coagulation cascades, immune response, transmembrane signaling, metabolism, cell cycle, stress control, invasion and vascularization. Nearly the same number of up-and downregulated genes participate in the same biological processes related to placental development and maintenance. Procedures utilized in IVF-ET altered the expression of first-trimester placental genes that are critical to these biological processes and triggered a compensatory mechanism during early implantation in vivo. Conclusion: These data provide a potential basis for further analysis of the higher frequency of adverse perinatal outcomes following IVF-ET, with the ultimate goal of developing safer IVF-ET protocols.

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“…This success rate is variable from 45% in patient having less than 35 years to 7% in patients having more than 42 years age which is due to the poor response of ovary to stimulation or hyperstimulation syndrome (7). Different previous studies have investigated the maternal or neonatal outcomes of ART (8)(9)(10)(11)(12)(13)(14). These studies have reported various problems in neonates concieved by ART or their mothers including multiple gestation, preterm labor, low birth weight and intra-uterine growth retardation (IUGR).…”

Section: Introductionmentioning

confidence: 99%

Infantile Prognosis of Neonates Conceived by Assisted Reproductive Techniques: A prospective Study

khoei

Afjeh

Tajalli

et al. 2020

Preprint

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Background: Outcomes of neonates of infertile couples that are golden babies and care of them is an issue of importance. But it is not yet clear if the prognosis is different between them and neonates from fertile couples. The purpose of this study was to determine the outcome of neonates conceived by assisted reproductive techniques. Methods:In this cohort study, a total of 165 newborn who were conceived by ART and 165 naturally concieved newborns were enrolled. The study was prospective from April 2016 to October 2017. All newborns were examined by neonatologist after birth and their outcome were followed up to oneyear. The outcomes were compared with neonates from fertile couple using appropriate statistical tests. Results:The preterm neonates (60% vs. 38%) were higher in ART cases (P<0.001). The mean gravid and parity were lower in ART group (P<0.001) and the nulliparity was higher in them. Multiple pregnancies were higher in ART cases (45% vs. 10%; P<0. 001). C/S rate was higher (91% vs 67%) in ART cases (P<0.001). Pre-eclampsia rate was higher in ART cases (16 % vs. 6%; P=0.004). Female sex was higher in ART group (P=0.035). Birth weight was significantly lower in ART group (P=0.002) and the Apgar was also lower (P=0.002; P=0.012). IUGR was significantly higher (17% vs. 7%) in ART group (P=0.006). NEC and RDS were more common in ART group (P<0.001). Hospital stay was longer in ART group (P<0.001). Re-admission, and weight less than 5th percentile were more common after one year in ART group (P=0.021). Conclusion:According to the obtained results, pregnancy after ART has more side effects before and after birth and also in infancy; not only because of multigestation but also due to manipulations in ART.

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Comparison of neonatal outcomes of very low birth weight infants by mode of conception: in vitro fertilization versus natural pregnancy

Cited by 17 publications

References 33 publications

Obstetrical and Perinatal Complications after Assisted Reproduction: what matters is age, not the procedure

Obstetrical and Perinatal Complications after Assisted Reproduction: what matters is age, not the procedure

The placental transcriptome of the first-trimester placenta is affected by in vitro fertilization and embryo transfer

Infantile Prognosis of Neonates Conceived by Assisted Reproductive Techniques: A prospective Study

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