A comparative study on pregnancy characteristics and preterm birth risks between assisted reproductive technology and natural conceived couples
10.3969/j.issn.1672-8467.2025.05.001
- VernacularTitle:辅助生殖技术与自然受孕夫妇的妊娠特征及早产风险比较研究
- Author:
Qiu-ping WAN
1
;
Xin CUI
;
Xiao-ming YANG
;
Nai-si QIAN
;
Shan JIN
;
Xiao-ting CHU
;
Chun-fang WANG
;
Hui-ting YU
Author Information
1. 上海市静安区疾病预防控制中心生命统计与肿瘤伤害防治科 上海 200072
- Publication Type:Journal Article
- Keywords:
assisted reproductive technology(ART);
single pregnancy;
twin and multiple pregnancy;
preterm birth(PTB)
- From:
Fudan University Journal of Medical Sciences
2025;52(5):617-628
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the differences in demographic characteristics,reproductive health status,and the distribution of pregnancy-related diseases between couples conceived via assisted reproductive technology(ART)and naturally conceived couples,and to analyze the impact of ART treatment on the incidence of preterm birth(PTB)in singleton and twin and multiple pregnancies.Methods We conducted a retrospective analysis of the maternal and infant cohort data of Jing'an District from 2013 to 2020.Based on the conception method,the subjects were categorized into two groups:the ART group and the natural conception group.Chi-square test was applied to compare baseline characteristics and disease distributions differences between the two groups,and logistic regression models were used to evaluate the association between ART and the PTB risks.A causal mediation model was used to evaluate the mediating effect of twin and multiple pregnancy in the relationship between ART and PTB.Results A total of 117 717 parturients were included,6 265 in the ART group and 111 452 in the natural conception group.Compared with the natural conception group,couples in the ART group were significantly older and had a higher prevalence of reproductive system diseases.The incidences of diabetes and hypertensive disorders during pregnancy in ART parturient were 13.76%and 9.99%,respectively,which were significantly higher than 7.88%and 4.75%in the natural conception group(both P<0.001).The overall PTB rate in the ART group was 14.81%,higher than 5.35%in the natural conceptions group(P<0.001).The PTB rate in ART for singleton pregnancies in the ART group was 6.40%,higher than 4.83%in the natural conception group(P<0.001),while the PTB rate in ART for twin and multiple pregnancies in the ART group was 53.97%,lower than 60.42%in the natural conception group(P<0.05).Mediation analysis showed that 97.99%of the effect of ART on PTB was mediated by twin and multiple pregnancy,with ART increasing the PTB risk by 3.44 times through multiple pregnancy.Conclusion The overall PTB rate of ART recipients is higher than that of natural recipients,but ART does not increase the PTB risk in singleton and twin and multiple pregnancies.Twin and multiple pregnancy is the key mediating factor contributing to PTB in ART-conceived recipients.Compared with naturally conceived couples,ART conception couples own more advanced maternal age,and have higher risks of suffering gestational diabetes,gestational hypertension,and PTB.
