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

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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