Effects of assisted reproductive technology on pregnant complications and outcomes: a birth cohort study

  Objective  To explore the effect of assisted reproductive technology (ART) on pregnancy complications and outcomes.

  Methods  The baseline data were from a birth cohort in Anhui province, China. A total of 4 428 pregnant women who received 1st prenatal care at Maternal and Child Health Center of Ma'anshan city from November 2008 to October 2010 were recruited. Basic demographic characteristics of the women and their husbands, special anxiety during pregnancy were collected with a questionnaire survey. Pregnant complications, such as gestational diabetes mellitus, intrahepatic cholestasis of pregnancy were recorded and information on delivery outcomes (gestational age, birth weight, delivery mode) were also collected.

  Results  The proportion of the women receiving ART was 3.7%. The detection rate of diabetes mellitus and intrahepatic cholestasis among the women with ART were 4.3% and 2.4%, respectively, and were significantly higher than those (1.5% and 0.6%) in the women without ART. Furthermore, the cesarean section rate was 76.8% among the women with ART and the rate was significantly higher than that (64.9%) in the women without ART. Multivariate logistic regression analysis demonstrated that the women with ART had higher risk of gestational diabetes mellitus (relative risk RR = 2.42, 95% confidence interval 95% CI: 1.08 – 5.43) and intrahepatic cholestasis of pregnancy (RR = 4.40, 95% CI: 1.51 – 12.82) and the women with ART were more likely to select cesarean section (RR = 1.66, 95% CI: 1.14 – 2.41) compared to the women without ART.

  Conclusion  Assisted reproductive technology is strongly associated with gestational diabetes mellitus and intrahepatic cholestasis of pregnancy. Pregnant women with ART are more likely to choose cesarean delivery.