目的：评估体外受精（IVF；供体和自体）妊娠与非IVF妊娠的缺血性胎盘疾病（IPD）风险。
方法：这是一项2000年至2015年在三级医院分娩的回顾性队列研究。曝光，捐赠者,自体IVF,与非IVF妊娠进行比较，供体IVF妊娠也与自体IVF妊娠进行比较。结果是IPD（先兆子痫，胎盘早剥,小于胎龄（SGA），或由于胎盘功能不全而导致的宫内胎儿死亡）。我们将SGA定义为胎龄和性别的出生体重<10百分位数。二次分析将SGA限制为<第三百分位数。
结果：在该队列中的69,084例分娩中，262来自供体IVF，3,501来自自体IVF。与非IVF妊娠相比，IPD在供体IVF妊娠（风险比（RR）=2.9;95％CI2.5-3.4）和自体IVF妊娠（RR=2.0;95％CI1.9-2.1）中更为常见，根据年龄和平价进行了调整。IVF妊娠更容易并发先兆子痫（供体RR=3.8;95％CI2.8-5.0，自体RR=2.2;95％CI2.0-2.5，根据年龄调整，奇偶校验，和婚姻状况)，胎盘早剥(供体RR=3.8;95%CI2.1-6.7,自体RR=2.5;95%CI2.1-3.1,校正年龄),和SGA（供体RR=2.7；95％CI2.1-3.4，自体RR=2.0；95％CI1.9-2.2，根据年龄和胎次调整）。将SGA限制为<第3百分位数的结果相似。
结论：与非IVF妊娠相比，使用供体IVF和自体IVF的妊娠发生IPD及其相关疾病的风险更高，并且供体IVF妊娠的相关性始终更强。
OBJECTIVE: Assess the risk of ischemic placental disease (IPD) among in vitro fertilization (IVF; donor and autologous) pregnancies compared with non-IVF pregnancies.
METHODS: This was a retrospective cohort
study of deliveries from 2000 to 2015 at a tertiary hospital. The exposures, donor, and autologous IVF, were compared with non-IVF pregnancies and donor IVF pregnancies were also compared with autologous IVF pregnancies. The outcome was IPD (preeclampsia, placental abruption, small for gestational age (SGA), or intrauterine fetal demise due to placental insufficiency). We defined SGA as birthweight < 10th percentiles for gestational age and sex. A secondary analysis restricted SGA to < 3rd percentile.
RESULTS: Of 69,084 deliveries in this cohort, 262 resulted from donor IVF and 3,501 from autologous IVF. Compared with non-IVF pregnancies, IPD was more common among donor IVF pregnancies (risk ratio (RR) = 2.9; 95% CI 2.5-3.4) and autologous IVF pregnancies (RR = 2.0; 95% CI 1.9-2.1), adjusted for age and parity. IVF pregnancies were more likely to be complicated by preeclampsia (donor RR = 3.8; 95% CI 2.8-5.0 and autologous RR = 2.2; 95% CI 2.0-2.5, adjusted for age, parity, and marital status), placental abruption (donor RR = 3.8; 95% CI 2.1-6.7 and autologous RR = 2.5; 95% CI 2.1-3.1, adjusted for age), and SGA (donor RR = 2.7; 95% CI 2.1-3.4 and autologous RR = 2.0; 95% CI 1.9-2.2, adjusted for age and parity). Results were similar when restricting SGA to < 3rd percentile.
CONCLUSIONS: Pregnancies conceived using donor IVF and autologous IVF were at higher risk of IPD and its associated conditions than non-IVF pregnancies and associations were consistently stronger for donor IVF pregnancies.
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