Abstract：
OBJECTIVE: What differences exist in the phenotypes of pre-eclampsia, perinatal outcomes and neonatal echocardiography between pregnancies conceived naturally and through IVF?
METHODS: Six hundred and ten women diagnosed with pre-eclampsia between January 2002 and December 2022 were included in this study. This research was conducted within the IVF and Maternal-Fetal Medicine Department of Kaohsiung Chang Gung Memorial Hospital, Taiwan. Participants were divided into two groups: those who achieved pregnancy through IVF, and those who conceived naturally. The phenotypes of pre-eclampsia and perinatal outcomes were assessed using a propensity-matched sample (n = 218), along with neonatal echocardiography.
RESULTS: After conducting propensity score matching, the natural conception group had a higher prevalence of early-onset pre-eclampsia (53.9% versus 37.7%, P = 0.04) and exhibited more severe features of pre-eclampsia (89.1% versus 69.8%, P = 0.01) compared with the IVF group. Regarding perinatal outcomes, neonates in the IVF group had higher placental weights compared with the natural conception group (580 versus 480 g, P = 0.031). The prevalence of abnormal findings on neonatal echocardiography was similar between the groups. Multivariate analysis showed that greater gestational age at delivery reduced the likelihood of abnormal findings on echocardiography [adjusted risk ratio (aRR) 0.950, P = 0.001], while pregestational diabetes mellitus increased the likelihood of abnormal findings (aRR 1.451, P = 0.044). Septal defects were the most common type of defect, occurring in 16.1% of infants.
CONCLUSIONS: The impact of IVF conception on the severity of pre-eclampsia is not as expected. Neonatal echocardiography revealed a higher prevalence of abnormalities in offspring of women with pre-eclampsia compared with the general population. However, these issues were not linked to the method of conception, suggesting the existence of undisclosed factors that could influence the clinical features and perinatal outcomes of pre-eclampsia.
METHODS: Six hundred and ten women diagnosed with pre-eclampsia between January 2002 and December 2022 were included in this study. This research was conducted within the IVF and Maternal-Fetal Medicine Department of Kaohsiung Chang Gung Memorial Hospital, Taiwan. Participants were divided into two groups: those who achieved pregnancy through IVF, and those who conceived naturally. The phenotypes of pre-eclampsia and perinatal outcomes were assessed using a propensity-matched sample (n = 218), along with neonatal echocardiography.
RESULTS: After conducting propensity score matching, the natural conception group had a higher prevalence of early-onset pre-eclampsia (53.9% versus 37.7%, P = 0.04) and exhibited more severe features of pre-eclampsia (89.1% versus 69.8%, P = 0.01) compared with the IVF group. Regarding perinatal outcomes, neonates in the IVF group had higher placental weights compared with the natural conception group (580 versus 480 g, P = 0.031). The prevalence of abnormal findings on neonatal echocardiography was similar between the groups. Multivariate analysis showed that greater gestational age at delivery reduced the likelihood of abnormal findings on echocardiography [adjusted risk ratio (aRR) 0.950, P = 0.001], while pregestational diabetes mellitus increased the likelihood of abnormal findings (aRR 1.451, P = 0.044). Septal defects were the most common type of defect, occurring in 16.1% of infants.
CONCLUSIONS: The impact of IVF conception on the severity of pre-eclampsia is not as expected. Neonatal echocardiography revealed a higher prevalence of abnormalities in offspring of women with pre-eclampsia compared with the general population. However, these issues were not linked to the method of conception, suggesting the existence of undisclosed factors that could influence the clinical features and perinatal outcomes of pre-eclampsia.
摘要：
目的：先兆子痫的表型存在哪些差异，自然妊娠和通过IVF妊娠之间的围产期结局和新生儿超声心动图检查?
方法:本研究纳入了2002年1月至2022年12月期间诊断为先兆子痫的6,10名妇女.这项研究是在高雄长庚纪念医院试管婴儿及母胎医学科内进行的,台湾。参与者分为两组：通过IVF怀孕的人，和那些自然怀孕的人。使用倾向匹配样本（n=218）评估先兆子痫的表型和围产期结局，还有新生儿超声心动图.
结果：进行倾向评分匹配后，自然受孕组早发型子痫前期患病率较高(53.9%对37.7%,P=0.04），并表现出更严重的先兆子痫特征（89.1％对69.8％，与IVF组比拟P=0.01。关于围产期结局，与自然受孕组相比，IVF组的新生儿胎盘重量更高（580对480g，P=0.031)。两组新生儿超声心动图异常发现的发生率相似。多因素分析显示，分娩时更大的胎龄降低了超声心动图异常发现的可能性[调整风险比（aRR）0.950，P=0.001]。而孕前糖尿病增加了异常发现的可能性(aRR1.451,P=0.044)。间隔缺损是最常见的缺损类型,发生在16.1％的婴儿中。
结论：IVF受孕对先兆子痫严重程度的影响并不像预期的那样。新生儿超声心动图显示，与普通人群相比，先兆子痫妇女的后代异常患病率更高。然而,这些问题与概念方法无关，提示存在可能影响子痫前期临床特征和围产期结局的未知因素。
方法:本研究纳入了2002年1月至2022年12月期间诊断为先兆子痫的6,10名妇女.这项研究是在高雄长庚纪念医院试管婴儿及母胎医学科内进行的,台湾。参与者分为两组：通过IVF怀孕的人，和那些自然怀孕的人。使用倾向匹配样本（n=218）评估先兆子痫的表型和围产期结局，还有新生儿超声心动图.
结果：进行倾向评分匹配后，自然受孕组早发型子痫前期患病率较高(53.9%对37.7%,P=0.04），并表现出更严重的先兆子痫特征（89.1％对69.8％，与IVF组比拟P=0.01。关于围产期结局，与自然受孕组相比，IVF组的新生儿胎盘重量更高（580对480g，P=0.031)。两组新生儿超声心动图异常发现的发生率相似。多因素分析显示，分娩时更大的胎龄降低了超声心动图异常发现的可能性[调整风险比（aRR）0.950，P=0.001]。而孕前糖尿病增加了异常发现的可能性(aRR1.451,P=0.044)。间隔缺损是最常见的缺损类型,发生在16.1％的婴儿中。
结论：IVF受孕对先兆子痫严重程度的影响并不像预期的那样。新生儿超声心动图显示，与普通人群相比，先兆子痫妇女的后代异常患病率更高。然而,这些问题与概念方法无关，提示存在可能影响子痫前期临床特征和围产期结局的未知因素。
