A mutual comparison of pregnancy outcomes between different conception modes: a propensity score matching based retrospective cohort study
BackgroundAssisted reproductive technology (ART) has been reported to have negative effects on maternal and neonatal health. Ovulation induction (OI) was reported to be associated with alteration of epigenetic modification of mice embryos, and extinguishing the influence of ovulation induction and i...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2024-01-01
|
| Series: | Frontiers in Endocrinology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2024.1351991/full |
| _version_ | 1827374954179461120 |
|---|---|
| author | Chang-Fa Sun Jian-Zhong Sheng He-Feng Huang He-Feng Huang He-Feng Huang He-Feng Huang |
| author_facet | Chang-Fa Sun Jian-Zhong Sheng He-Feng Huang He-Feng Huang He-Feng Huang He-Feng Huang |
| author_sort | Chang-Fa Sun |
| collection | DOAJ |
| description | BackgroundAssisted reproductive technology (ART) has been reported to have negative effects on maternal and neonatal health. Ovulation induction (OI) was reported to be associated with alteration of epigenetic modification of mice embryos, and extinguishing the influence of ovulation induction and in vitro operations on maternal and neonatal health will bring benefits for reducing side effects. The present study aimed to determine whether ovulation induction alone and ART are associated with adverse pregnancy outcomes and whether ART could induce a higher risk than ovulation induction alone.MethodsA total of 51,172 cases with singleton live birth between Jan 2016 and May 2019 at the International Peace Maternal and Child Health Hospital were included in this study. Conception modes documented during registration were classified into natural conception (NC), OI, and ART. Pregnancy outcomes of the three groups with balanced baseline characteristics by propensity score matching were compared. The relative risks of maternal and neonatal outcomes were calculated by logistic regression analysis.ResultsCompared with natural conception, infertility treatments are associated with gestational diabetes (OI: OR 1.72, 95% CI 1.31-2.27; ART: OR 1.67, 95% CI 1.26-2.20), preeclampsia/eclampsia (OI: OR 1.86, 95% CI 1.03-3.36; ART: OR 2.23, 95% CI 1.26-3.92). Even if gestational diabetes, gestational hypertension, and placental problems were adjusted, infertility treatments are associated with birth before 37 weeks (OI: OR 1.99, 95% CI 1.28-3.12; ART: OR 1.70, 95% CI 1.08-2.69), low birth weight (OI: OR 2.19, 95% CI 1.23-3.91; ART: OR 1.90, 95% CI 1.05-3.45), and SGA (OI: OR 2.42, 95% CI 1.20-4.87; ART: OR 2.56, 95% CI 1.28-5.11). ART but not OI is associated with a higher risk of birth before 34 weeks (OR:3.12, 95% CI 1.21-8.05). By comparing the OI group with the ART group, we only found that ART could induce a higher ratio of placental problems (5.0%, 26/518 vs 2.1%, 11/519, p<0.05).ConclusionBoth OI and ART are associated with adverse pregnancy outcomes. ART induced comparable negative effects with OI on gestational complications, birth weight, and premature birth (<37 weeks). However, ART resulted in a higher risk of placental problems than group NC and OI. The incidence of birth before 34 weeks of gestation in the ART group tends to be higher than in the OI group, but not statistically significant. The side effects of ART may originate from OI. |
| first_indexed | 2024-03-08T11:43:44Z |
| format | Article |
| id | doaj.art-b7dcf4cf341b4a01b65053d8d871c6f8 |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-03-08T11:43:44Z |
| publishDate | 2024-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-b7dcf4cf341b4a01b65053d8d871c6f82024-01-25T04:32:39ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922024-01-011510.3389/fendo.2024.13519911351991A mutual comparison of pregnancy outcomes between different conception modes: a propensity score matching based retrospective cohort studyChang-Fa Sun0Jian-Zhong Sheng1He-Feng Huang2He-Feng Huang3He-Feng Huang4He-Feng Huang5Centre for Reproductive Medicine, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, ChinaInternational Institutes of Medicine, the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, ChinaInternational Institutes of Medicine, the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, ChinaInternational Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaObstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, ChinaObstetrics and Gynecology Hospital, Key Laboratory of Reproductive Genetics (Ministry of Education), School of Medicine, Zhejiang University, Hangzhou, ChinaBackgroundAssisted reproductive technology (ART) has been reported to have negative effects on maternal and neonatal health. Ovulation induction (OI) was reported to be associated with alteration of epigenetic modification of mice embryos, and extinguishing the influence of ovulation induction and in vitro operations on maternal and neonatal health will bring benefits for reducing side effects. The present study aimed to determine whether ovulation induction alone and ART are associated with adverse pregnancy outcomes and whether ART could induce a higher risk than ovulation induction alone.MethodsA total of 51,172 cases with singleton live birth between Jan 2016 and May 2019 at the International Peace Maternal and Child Health Hospital were included in this study. Conception modes documented during registration were classified into natural conception (NC), OI, and ART. Pregnancy outcomes of the three groups with balanced baseline characteristics by propensity score matching were compared. The relative risks of maternal and neonatal outcomes were calculated by logistic regression analysis.ResultsCompared with natural conception, infertility treatments are associated with gestational diabetes (OI: OR 1.72, 95% CI 1.31-2.27; ART: OR 1.67, 95% CI 1.26-2.20), preeclampsia/eclampsia (OI: OR 1.86, 95% CI 1.03-3.36; ART: OR 2.23, 95% CI 1.26-3.92). Even if gestational diabetes, gestational hypertension, and placental problems were adjusted, infertility treatments are associated with birth before 37 weeks (OI: OR 1.99, 95% CI 1.28-3.12; ART: OR 1.70, 95% CI 1.08-2.69), low birth weight (OI: OR 2.19, 95% CI 1.23-3.91; ART: OR 1.90, 95% CI 1.05-3.45), and SGA (OI: OR 2.42, 95% CI 1.20-4.87; ART: OR 2.56, 95% CI 1.28-5.11). ART but not OI is associated with a higher risk of birth before 34 weeks (OR:3.12, 95% CI 1.21-8.05). By comparing the OI group with the ART group, we only found that ART could induce a higher ratio of placental problems (5.0%, 26/518 vs 2.1%, 11/519, p<0.05).ConclusionBoth OI and ART are associated with adverse pregnancy outcomes. ART induced comparable negative effects with OI on gestational complications, birth weight, and premature birth (<37 weeks). However, ART resulted in a higher risk of placental problems than group NC and OI. The incidence of birth before 34 weeks of gestation in the ART group tends to be higher than in the OI group, but not statistically significant. The side effects of ART may originate from OI.https://www.frontiersin.org/articles/10.3389/fendo.2024.1351991/fullOIartpreterm birthlow birth weightgestational diabetes |
| spellingShingle | Chang-Fa Sun Jian-Zhong Sheng He-Feng Huang He-Feng Huang He-Feng Huang He-Feng Huang A mutual comparison of pregnancy outcomes between different conception modes: a propensity score matching based retrospective cohort study Frontiers in Endocrinology OI art preterm birth low birth weight gestational diabetes |
| title | A mutual comparison of pregnancy outcomes between different conception modes: a propensity score matching based retrospective cohort study |
| title_full | A mutual comparison of pregnancy outcomes between different conception modes: a propensity score matching based retrospective cohort study |
| title_fullStr | A mutual comparison of pregnancy outcomes between different conception modes: a propensity score matching based retrospective cohort study |
| title_full_unstemmed | A mutual comparison of pregnancy outcomes between different conception modes: a propensity score matching based retrospective cohort study |
| title_short | A mutual comparison of pregnancy outcomes between different conception modes: a propensity score matching based retrospective cohort study |
| title_sort | mutual comparison of pregnancy outcomes between different conception modes a propensity score matching based retrospective cohort study |
| topic | OI art preterm birth low birth weight gestational diabetes |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2024.1351991/full |
| work_keys_str_mv | AT changfasun amutualcomparisonofpregnancyoutcomesbetweendifferentconceptionmodesapropensityscorematchingbasedretrospectivecohortstudy AT jianzhongsheng amutualcomparisonofpregnancyoutcomesbetweendifferentconceptionmodesapropensityscorematchingbasedretrospectivecohortstudy AT hefenghuang amutualcomparisonofpregnancyoutcomesbetweendifferentconceptionmodesapropensityscorematchingbasedretrospectivecohortstudy AT hefenghuang amutualcomparisonofpregnancyoutcomesbetweendifferentconceptionmodesapropensityscorematchingbasedretrospectivecohortstudy AT hefenghuang amutualcomparisonofpregnancyoutcomesbetweendifferentconceptionmodesapropensityscorematchingbasedretrospectivecohortstudy AT hefenghuang amutualcomparisonofpregnancyoutcomesbetweendifferentconceptionmodesapropensityscorematchingbasedretrospectivecohortstudy AT changfasun mutualcomparisonofpregnancyoutcomesbetweendifferentconceptionmodesapropensityscorematchingbasedretrospectivecohortstudy AT jianzhongsheng mutualcomparisonofpregnancyoutcomesbetweendifferentconceptionmodesapropensityscorematchingbasedretrospectivecohortstudy AT hefenghuang mutualcomparisonofpregnancyoutcomesbetweendifferentconceptionmodesapropensityscorematchingbasedretrospectivecohortstudy AT hefenghuang mutualcomparisonofpregnancyoutcomesbetweendifferentconceptionmodesapropensityscorematchingbasedretrospectivecohortstudy AT hefenghuang mutualcomparisonofpregnancyoutcomesbetweendifferentconceptionmodesapropensityscorematchingbasedretrospectivecohortstudy AT hefenghuang mutualcomparisonofpregnancyoutcomesbetweendifferentconceptionmodesapropensityscorematchingbasedretrospectivecohortstudy |