Srpski arhiv za celokupno lekarstvo 2015 Volume 143, Issue 9-10, Pages: 632-638
https://doi.org/10.2298/SARH1510632S
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Perinatal outcomes of pregnancies conceived by assisted reproductive technologies
Šljivančanin Tamara (Gynecology and Obstetrics Clinic “Narodni Front”, Belgrade)
Kontić-Vučinić Olivera (Clinic for Gynecology and Obstetrics, Clinical Center of Serbia, Belgrade)
Introduction. Recent epidemiological studies showed significantly higher
incidence of perinatal complications in newborns and women after the use of
assisted reproductive technologies (ART). Multiple pregnancies are more
frequent after the use of ART. Singleton pregnancies following ART are more
prone to preterm birth, low and very low birth weight (LBW and VLBW), small
for gestational age (SGA) and perinatal mortality. Objective. The aim of this
study was to summarize the results of relevant articles and to evaluate
whether the mode of conception is the determining factor for different
pregnancy outcomes after assisted and natural conceptions. Methods. Eleven
studies were included in this review. The following outcomes were observed:
preterm and very preterm birth, SGA, LBW, VLBW, perinatal mortality,
admission to neonatal intensive care unit (NICU), and Apgar score (As) ≤7 at
fifth minute. Qualitative analysis and quantitative assessment were
performed. Results. For singletons, odds ratios were 1.794 (95% confidence
interval 1.660-1.939) for preterm birth, 1.649 (1.301-2.089) for LBW, 1.265
(1.048-1.527) for SGA. Admission to NICU, As≤7 at fifth minute and perinatal
mortality showed significantly different frequency after assisted conception.
Summary of results for twin gestations showed no significant difference
between ART and spontaneous conception for preterm birth (32-36 weeks), very
preterm birth (<32 weeks), LBW and VLBW. Conclusion. Analyzed studies showed
that infants from ART have significantly worse perinatal outcome compared
with natural conception. More observational studies should be conducted in
order to establish the exact mechanism leading to more frequent perinatal
morbidity and mortality after the use of ART.
Keywords: assisted reproductive techniques, fertilization in vitro, pregnancy outcome, newborn