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Heshmatnia, F., Jafari, M., Bozorgian, L., Yadollahi, P., Khalajinia, Z., & Azizi, M. (2023). Is there a relationship between assisted reproductive technology and maternal outcomes? A systematic review of cohort studies. International Journal of Reproductive BioMedicine (IJRM), 21(11), 861–880. https://doi.org/10.18502/ijrm.v21i11.14651
https://doi.org/10.18502/ijrm.v21i11.14651
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authors
-
Fatemeh Heshmatnia
Fatemeh Heshmatnia
Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
-
Maryam Jafari
Maryam Jafari
Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
-
Leila Bozorgian
Leila Bozorgian
Student Research Committee, Nursing and Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
-
Parvin Yadollahi
Parvin Yadollahi
Department of Midwifery, Maternal-Fetal Medicine Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
-
Zohre Khalajinia
Zohre Khalajinia
Department of Midwifery, School of Medicine, Qom University of Medical Sciences, Qom, Iran.
-
Marzieh Azizi
Marzieh Azizi
Department of Midwifery, Sexual and Reproductive Health Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
Published Date
- Dec 14, 2023
Is there a relationship between assisted reproductive technology and maternal outcomes? A systematic review of cohort studies
Abstract
Background: Pregnancy with assisted reproductive technology (ART) is accompanied by fetal and maternal outcomes.
Objective: This systematic review aimed to assess the relationship between ART and maternal outcomes.
Materials and Methods: In this systematic review, the electronic databases, including PubMed, MEDLINE, Web of Science, Scopus, Science Direct, Cochrane Library, Google Scholar, Magiran, Irandoc, and Scientific Information Database were searched for maternal outcomes reported from 2010-2021. The Newcastle-Ottawa Scale for cohort studies was used to assess the methodological quality of studies.
Results: A total of 3362 studies were identified by searching the databases. After screening abstracts and full-text reviews, 19 studies assessing the singleton pregnancy-related complications of in vitro fertilization/intracytoplasmic sperm injection were included in the study. The results demonstrated that singleton pregnancies conceived through ART had higher risks of pregnancy-related complications and adverse maternal outcomes, such as vaginal bleeding, cesarean section, hypertension induced by pregnancy, pre-eclampsia, placenta previa, and premature membrane rupture than those conceived naturally.
Conclusion: In conclusion, an increased risk of adverse obstetric outcomes was observed in singleton pregnancies conceived by ART. Therefore, obstetricians should consider these pregnancies as high-risk cases and should pay special attention to their pregnancy process.
Key words: Assisted reproductive techniques, Maternal health, Pregnancy complications, In vitro fertilization.
References
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[49] Qin J-B, Sheng X-Q, Wu D, Gao Sh-Y, You Y-P, Yang T-B, et al. Worldwide prevalence of adverse pregnancy outcomes among singleton pregnancies after in vitro fertilization/intracytoplasmic sperm injection: A systematic review and meta-analysis. Arch Gynecol Obstet 2017; 295: 285–301.
[50] Chih HJ, Elias FTS, Gaudet L, Velez MP. Assisted reproductive technology and hypertensive disorders of pregnancy: Systematic review and meta-analyses. BMC Pregnancy Childbirth 2021; 21: 449.
[51] Nyfløt LT, Sandven I, Oldereid NB, Stray-Pedersen B, Vangen S. Assisted reproductive technology and severe postpartum haemorrhage: A case-control study. BJOG 2017; 124: 1198–1205.
[52] Luke B, Brown MB, Wantman E, Forestieri NE, Browne ML, Fisher SC, et al. The risk of birth defects with conception by ART. Hum Reprod 2021; 36: 116–129.
[53] Bosch E, De Vos M, Humaidan P. The future of cryopreservation in assisted reproductive technologies. Front Endocrinol 2020; 11: 67.
[54] Hansen M, Kurinczuk JJ, Bower C, Webb S. The risk of major birth defects after intracytoplasmic sperm injection and in vitro fertilization. N Engl J Med 2002; 346: 725–730.
[55] Hansen M, Kurinczuk JJ, de Klerk N, Burton P, Bower C. Assisted reproductive technology and major birth defects in Western Australia. Obstet Gynecol 2012; 120: 852–863.
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[57] Hayashi M, Nakai A, Satoh S, Matsuda Y. Adverse obstetric and perinatal outcomes of singleton pregnancies may be related to maternal factors associated with infertility rather than the type of assisted reproductive technology procedure used. Fertil Steril 2012; 98: 922–928.
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[2] Hu K-L, Ye X, Wang S, Zhang D. Melatonin application in assisted reproductive technology: A systematic review and meta-analysis of randomized trials. Front Endocrinol 2020; 11: 160–171.
[3] Maharlouei N, Morshed Behbahani B, Doryanizadeh L, Kazemi M. Prevalence and pattern of infertility in Iran: A systematic review and meta-analysis study. Women Health Bull 2021; 8: 63–71.
[4] Akhondi MM, Ranjbar F, Shirzad M, Behjati Ardakani Z, Kamali K, Mohammad K. Practical difficulties in estimating the prevalence of primary infertility in Iran. Int J Fertil Steril 2019; 13: 113–117.
[5] Li F, Niu AQ, Feng XM, Yan Y, Chen Y. The threshold effect of factors associated with spontaneous abortion in human-assisted reproductive technology. Sci Rep 2021; 11: 11368.
[6] Rodriguez-Wallberg KA, Lundberg FE, Ekberg S, Johansson AL, Ludvigsson JF, Almqvist C, et al. Mortality from infancy to adolescence in singleton children conceived from assisted reproductive techniques versus naturally conceived singletons in Sweden. Fertil Steril 2020; 113: 524–532.
[7] Zhang L, Zhang W, Xu H, Liu K. Birth defects surveillance after assisted reproductive technology in Beijing: A whole of population-based cohort study. BMJ Open 2021; 11: e044385.
[8] Chang J, Zhang Y, Boulet ShL, Crawford SB, Copeland GE, Bernson D, et al. Assisted reproductive technology and perinatal mortality: Selected states (2006–2011). Am J Perinatol 2023; 40: 953–959.
[9] Norrman E. Long-term outcome of children born after assisted reproductive technology
[thesis]. Gothenburg: Sweden; 2020.
[10] Wennerholm U-B, Bergh Ch. Perinatal outcome in children born after assisted reproductive technologies. Ups J Med Sci 2020; 125: 158–166.
[11] Cui L, Zhou W, Xi B, Ma J, Hu J, Fang M, et al. Increased risk of metabolic dysfunction in children conceived by assisted reproductive technology. Diabetologia 2020; 63: 2150–2157.
[12] Han Y, Luo H, Zhang Y. Congenital anomalies in infants conceived by infertile women through assisted reproductive technology: A cohort study 2004-2014. Exp Ther Med 2018; 16: 3179–3185.
[13] Opdahl S, Henningsen AA, Tiitinen A, Bergh C, Pinborg A, Romundstad P, et al. Risk of hypertensive disorders in pregnancies following assisted reproductive technology: A cohort study from the CoNARTaS group. Hum Reprod 2015; 30: 1724–1731.
[14] Morency A-M, Shah PS, Seaward PGR, Whittle W, Murphy KE. Obstetrical and neonatal outcomes of triplet births-spontaneous versus assisted reproductive technology conception. J Matern Fetal Neonatal Med 2016; 29: 938–943.
[15] Jin X-Y, Li Ch, Xu W, Liu L, Wei M-L, Fei H-Y, et al. Factors associated with the incidence of ectopic pregnancy in women undergoing assisted reproductive treatment. Chin Med J 2020; 133: 2054–2060.
[16] Berntsen S, Pinborg A. Large for gestational age and macrosomia in singletons born after frozen/thawed embryo transfer (FET) in assisted reproductive technology (ART). Birth Defects Res 2018; 110: 630–643.
[17] Cromi A, Candeloro I, Marconi N, Casarin J, Serati M, Agosti M, et al. Risk of peripartum hysterectomy in births after assisted reproductive technology. Fertil Steril 2016; 106: 623–628.
[18] Rashid D, Alalaf S. Maternal and perinatal outcomes in twin pregnancies conceived spontaneously and by assisted reproductive techniques: Cross-sectional study. East Mediterr Health J 2020; 26: 1285–1293.
[19] Gourounti K. Psychological stress and adjustment in pregnancy following assisted reproductive technology and spontaneous conception: A systematic review. Women Health 2016; 56: 98–118.
[20] Gdańska P, Drozdowicz-Jastrzębska E, Grzechocińska B, Radziwon-Zaleska M, Węgrzyn P, Wielgoś M. Anxiety and depression in women undergoing infertility treatment. Ginekol Pol 2017; 88: 109–112.
[21] Nicoloro-SantaBarbara J, Busso C, Moyer A, Lobel M. Just relax and you’ll get pregnant? Meta-analysis examining women’s emotional distress and the outcome of assisted reproductive technology. Soc Sci Med 2018; 213: 54–62.
[22] Katalinic A, Rösch C, Ludwig M, Group GIF-US. Pregnancy course and outcome after intracytoplasmic sperm injection: A controlled, prospective cohort study. Fertil Steril 2004; 81: 1604–1616.
[23] Mozafari Kermani R, Farhangniya M, Shahzadeh Fazeli SA, Bagheri P, Ashrafi M, Vosough Taqi Dizaj A. Congenital malformations in singleton infants conceived by assisted reproductive technologies and singleton infants by natural conception in Tehran, Iran. Int J Fertil Steril 2018; 11: 304–308.
[24] Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: Explanation and elaboration. PLoS Med 2009; 6: e1000100.
[25] Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev 2015; 4: 1–9.
[26] Wells GA, Shea B, O’Connell D, Peterson J, Welch V, Losos M, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses 2014. Available at: https://api.semanticscholar.org/CorpusID:79550924.
[27] Stang A. Critical evaluation of the Newcastle-Ottawa Scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol 2010; 25: 603–605.
[28] Margulis AV, Pladevall M, Riera-Guardia N, Varas-Lorenzo C, Hazell L, Berkman ND, et al. Quality assessment of observational studies in a drug-safety systematic review, comparison of two tools: The Newcastle-Ottawa scale and the RTI item bank. Clin Epidemiol 2014; 6: 359–368.
[29] Peterson J, Welch V, Losos M, Tugwell PJ. The Newcastle-Ottawa scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Ottawa: Ottawa Hospital Research Institute; 2011.
[30] Luchini C, Stubbs B, Solmi M, Veronese N. Assessing the quality of studies in meta-analyses: Advantages and limitations of the Newcastle Ottawa Scale. World J Meta-Anal 2017; 5: 80–84.
[31] Perri T, Chen R, Yoeli R, Merlob P, Orvieto R, Shalev Y, et al. Clinical assisted reproduction: Are singleton assisted reproductive technology pregnancies at risk of prematurity? J Assist Reprod Genet 2001; 18: 245–249.
[32] Farhi A, Reichman B, Boyko V, Hourvitz A, Ron-El R, Lerner-Geva L. Maternal and neonatal health outcomes following assisted reproduction. Reprod Biomed Online 2013; 26: 454–461.
[33] Poon WB, Lian WB. Perinatal outcomes of intrauterine insemination/clomiphene pregnancies represent an intermediate risk group compared with in vitro fertilisation/intracytoplasmic sperm injection and naturally conceived pregnancies. J Paediatr Child Health 2013; 49: 733–740.
[34] Jie Zh, Yiling D, Ling Y. Association of assisted reproductive technology with adverse pregnancy outcomes. Iran J Reprod Med 2015; 13: 169–180.
[35] Zhu L, Zhang Y, Liu Y, Zhang R, Wu Y, Huang Y, et al. Maternal and live-birth outcomes of pregnancies following assisted reproductive technology: A retrospective cohort study. Sci Rep 2016; 6: 35141.
[36] Lei L-L, Lan Y-L, Wang S-Y, Feng W, Zhai Z-J. Perinatal complications and live-birth outcomes following assisted reproductive technology: A retrospective cohort study. Chin Med J 2019; 132: 2408–2416.
[37] Wang Y, Yao Z, Zhao H, Yue C, Yu Q, Zhang Y, et al. Reproductive outcomes of in vitro fertilization-intracytoplasmic sperm injection after transcervical resection of adhesions: A retrospective cohort study. J Minim Invasive Gynecol 2021; 28: 1367–1374.
[38] Tanaka H, Tanaka K, Osato K, Kusaka H, Maegawa Y, Taniguchi H, et al. Evaluation of maternal and neonatal outcomes of assisted reproduction technology: A retrospective cohort study. Medicina 2020; 56: 32.
[39] Koudstaal J, Braat D, Bruinse H, Naaktgeboren N, Vermeiden J, Visser G. Obstetric outcome of singleton pregnancies after IVF: A matched control study in four Dutch university hospitals. Hum Reprod 2000; 15: 1819–1825.
[40] Isaksson R, Gissler M, Tiitinen A. Obstetric outcome among women with unexplained infertility after IVF: A matched case-control study. Hum Reprod 2000; 15: 1819–1825.
[41] Kozinszky Z, Zádori J, Orvos H, Katona M, Pál A, Kovács L. Obstetric and neonatal risk of pregnancies after assisted reproductive technology: A matched control study. Acta Obstet Gynecol Scand 2003; 82: 850–856.
[42] Poikkeus P, Gissler M, Unkila-Kallio L, Hyden-Granskog C, Tiitinen A. Obstetric and neonatal outcome after single embryo transfer. Hum Reprod 2007; 22: 1073–1079.
[43] Apantaku O, Chandrasekaran I, Bentick B. Obstetric outcome of singleton pregnancies achieved with in vitro fertilisation and intracytoplasmic sperm injection: Experience from a district general hospital. J Obstet Gynaecol 2008; 28: 398–402.
[44] Szymusik I, Kosinska-Kaczynska K, Krowicka M, Sep M, Marianowski P, Wielgos M. Perinatal outcome of in vitro fertilization singletons-10 years’ experience of one center. Arch Med Sci 2019; 15: 666–672.
[45] Schieve LA, Cohen B, Nannini A, Ferre C, Reynolds MA, Zhang Z, et al. A population-based study of maternal and perinatal outcomes associated with assisted reproductive technology in Massachusetts. Matern Child Health J 2007; 11: 517–525.
[46] da Silva SG, da Silveira MF, Bertoldi AD, Domingues MR, Dos Santos IDS. Maternal and child-health outcomes in pregnancies following assisted reproductive technology (ART): A prospective cohort study. BMC Pregnancy Childbirth 2020; 20: 106.
[47] Jaques AM, Amor DJ, Baker HG, Healy DL, Ukoumunne OC, Breheny S, et al. Adverse obstetric and perinatal outcomes in subfertile women conceiving without assisted reproductive technologies. Fertil Steril 2010; 94: 2674–2679.
[48] Wen ShW, Leader A, White RR, Léveillé M-C, Wilkie V, Zhou J, et al. A comprehensive assessment of outcomes in pregnancies conceived by in vitro fertilization/intracytoplasmic sperm injection. Eur J Obstet Gynecol Reprod Biol 2010; 150: 160–165.
[49] Qin J-B, Sheng X-Q, Wu D, Gao Sh-Y, You Y-P, Yang T-B, et al. Worldwide prevalence of adverse pregnancy outcomes among singleton pregnancies after in vitro fertilization/intracytoplasmic sperm injection: A systematic review and meta-analysis. Arch Gynecol Obstet 2017; 295: 285–301.
[50] Chih HJ, Elias FTS, Gaudet L, Velez MP. Assisted reproductive technology and hypertensive disorders of pregnancy: Systematic review and meta-analyses. BMC Pregnancy Childbirth 2021; 21: 449.
[51] Nyfløt LT, Sandven I, Oldereid NB, Stray-Pedersen B, Vangen S. Assisted reproductive technology and severe postpartum haemorrhage: A case-control study. BJOG 2017; 124: 1198–1205.
[52] Luke B, Brown MB, Wantman E, Forestieri NE, Browne ML, Fisher SC, et al. The risk of birth defects with conception by ART. Hum Reprod 2021; 36: 116–129.
[53] Bosch E, De Vos M, Humaidan P. The future of cryopreservation in assisted reproductive technologies. Front Endocrinol 2020; 11: 67.
[54] Hansen M, Kurinczuk JJ, Bower C, Webb S. The risk of major birth defects after intracytoplasmic sperm injection and in vitro fertilization. N Engl J Med 2002; 346: 725–730.
[55] Hansen M, Kurinczuk JJ, de Klerk N, Burton P, Bower C. Assisted reproductive technology and major birth defects in Western Australia. Obstet Gynecol 2012; 120: 852–863.
[56] Basso O, Baird DD. Infertility and preterm delivery, birthweight, and caesarean section: A study within the Danish national birth cohort. Hum Reprod 2003; 18: 2478–2484.
[57] Hayashi M, Nakai A, Satoh S, Matsuda Y. Adverse obstetric and perinatal outcomes of singleton pregnancies may be related to maternal factors associated with infertility rather than the type of assisted reproductive technology procedure used. Fertil Steril 2012; 98: 922–928.
[58] Marino JL, Moore VM, Willson KJ, Rumbold A, Whitrow MJ, Giles LC, et al. Perinatal outcomes by mode of assisted conception and sub-fertility in an Australian data linkage cohort. PLoS One 2014; 9: e80398.
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