Abstract：
OBJECTIVE: We set out to compare adverse pregnancy and neonatal outcomes in singleton gestations conceived via in vitro fertilization (IVF) to those conceived spontaneously.
METHODS: Retrospective, population-based cohort using the CDC Natality Live Birth database (2016-2021). All singleton births were stratified into two groups: those conceived via IVF, and those conceived spontaneously. The incidence of several adverse pregnancy and neonatal outcomes was compared between the two groups using Pearson\'s chi-square test with Bonferroni adjustments. Multivariate logistic regression was used to adjust outcomes for potential confounders.
RESULTS: Singleton live births conceived by IVF comprised 0.86 % of the cohort (179,987 of 20,930,668). Baseline characteristics varied significantly between the groups. After adjusting for confounding variables, pregnancies conceived via IVF were associated with an increased risk of several adverse pregnancy and neonatal outcomes compared to those conceived spontaneously. The maternal adverse outcomes with the highest risk in IVF pregnancies included maternal transfusion, unplanned hysterectomy, and maternal intensive care unit admission. Increased rates of hypertensive disorder of pregnancy, preterm birth (delivery <37 weeks of gestation), and cesarean delivery were also noted. The highest risk neonatal adverse outcomes associated with IVF included immediate and prolonged ventilation, neonatal seizures, and neonatal intensive care unit admissions, among others.
CONCLUSIONS: Based on this large contemporary United States cohort, the risk of several adverse pregnancy and neonatal outcomes is increased in singleton pregnancies conceived via IVF compared to those conceived spontaneously. Obstetricians should be conscious of these associations while caring for and counseling pregnancies conceived via IVF.
METHODS: Retrospective, population-based cohort using the CDC Natality Live Birth database (2016-2021). All singleton births were stratified into two groups: those conceived via IVF, and those conceived spontaneously. The incidence of several adverse pregnancy and neonatal outcomes was compared between the two groups using Pearson\'s chi-square test with Bonferroni adjustments. Multivariate logistic regression was used to adjust outcomes for potential confounders.
RESULTS: Singleton live births conceived by IVF comprised 0.86 % of the cohort (179,987 of 20,930,668). Baseline characteristics varied significantly between the groups. After adjusting for confounding variables, pregnancies conceived via IVF were associated with an increased risk of several adverse pregnancy and neonatal outcomes compared to those conceived spontaneously. The maternal adverse outcomes with the highest risk in IVF pregnancies included maternal transfusion, unplanned hysterectomy, and maternal intensive care unit admission. Increased rates of hypertensive disorder of pregnancy, preterm birth (delivery <37 weeks of gestation), and cesarean delivery were also noted. The highest risk neonatal adverse outcomes associated with IVF included immediate and prolonged ventilation, neonatal seizures, and neonatal intensive care unit admissions, among others.
CONCLUSIONS: Based on this large contemporary United States cohort, the risk of several adverse pregnancy and neonatal outcomes is increased in singleton pregnancies conceived via IVF compared to those conceived spontaneously. Obstetricians should be conscious of these associations while caring for and counseling pregnancies conceived via IVF.
摘要：
目的：我们着手比较通过体外受精（IVF）与自发受孕的单胎妊娠的不良妊娠和新生儿结局。
方法：回顾性，使用CDC自然活产数据库(2016-2021年)的基于人群的队列。所有单胎分娩都分为两组：通过试管婴儿怀孕的，和那些自发构思的。使用Pearson卡方检验和Bonferroni校正比较两组之间几种不良妊娠和新生儿结局的发生率。多变量逻辑回归用于调整潜在混杂因素的结果。
结果：试管婴儿受孕的单胎活产占队列的0.86%（17987/20,930,668）。组间基线特征差异显著。调整混杂变量后，与自然受孕者相比,通过IVF受孕的妊娠与几种不良妊娠和新生儿结局的风险增加相关.IVF妊娠中风险最高的孕产妇不良结局包括孕产妇输血，计划外子宫切除术,和孕产妇重症监护病房入院。妊娠期高血压疾病的发病率增加，早产（分娩<妊娠37周），和剖宫产也注意到。与IVF相关的最高风险新生儿不良结局包括立即通气和延长通气，新生儿癫痫,和新生儿重症监护室入院，在其他人中。
结论：基于这个庞大的当代美国队列，与自然受孕的单胎妊娠相比,通过IVF受孕的单胎妊娠发生几种不良妊娠和新生儿结局的风险增加.产科医生在照顾和咨询通过IVF构思的怀孕时应该意识到这些关联。
方法：回顾性，使用CDC自然活产数据库(2016-2021年)的基于人群的队列。所有单胎分娩都分为两组：通过试管婴儿怀孕的，和那些自发构思的。使用Pearson卡方检验和Bonferroni校正比较两组之间几种不良妊娠和新生儿结局的发生率。多变量逻辑回归用于调整潜在混杂因素的结果。
结果：试管婴儿受孕的单胎活产占队列的0.86%（17987/20,930,668）。组间基线特征差异显著。调整混杂变量后，与自然受孕者相比,通过IVF受孕的妊娠与几种不良妊娠和新生儿结局的风险增加相关.IVF妊娠中风险最高的孕产妇不良结局包括孕产妇输血，计划外子宫切除术,和孕产妇重症监护病房入院。妊娠期高血压疾病的发病率增加，早产（分娩<妊娠37周），和剖宫产也注意到。与IVF相关的最高风险新生儿不良结局包括立即通气和延长通气，新生儿癫痫,和新生儿重症监护室入院，在其他人中。
结论：基于这个庞大的当代美国队列，与自然受孕的单胎妊娠相比,通过IVF受孕的单胎妊娠发生几种不良妊娠和新生儿结局的风险增加.产科医生在照顾和咨询通过IVF构思的怀孕时应该意识到这些关联。
