Association of Abnormal Placental Cord Insertion With Assisted Reproductive Technology [20A

Abstract

INTRODUCTION: Abnormal placental cord insertion has been associated with an increase in preterm delivery, low birth weight, neonatal intensive care admissions and cesarean delivery. Assisted reproductive technology (ART) has been associated with some similar placenta-medicated pregnancy complications. We hypothesize an increase in abnormal placental cord insertion in pregnancies conceived using ART, thereby contributing to the increased association of adverse pregnancy outcomes. METHODS: We performed an IRB approved, retrospective chart review of 3728 singleton and twin placentas sent to pathology at the University of Massachusetts between January 2011-January 2016. Placental pathology reports were reviewed and evidence of abnormal placental cord insertion, either velamentous or marginal, were recorded. Chi-square test was used for categorical variables and student T-test for continuous. Logistic regression was used to control for potential confounders. P less than 0.05 was used for statistical significance. RESULTS: Of the 3728 pregnancies, 3615 were conceived via spontaneous conception, whereas 113 were conceived through ART. Women who conceived with ART were more likely to be married, of white race, older and have multiple gestations than those with spontaneous conception. ART pregnancies were over 2-fold more likely to have abnormal placental cord insertions (OR 2.1 [1.1–3.9], P=.03). After adjusting for confounding factors, statistical significance was no longer noted. CONCLUSION: Pregnancies conceived with ART were more likely to have abnormal placental cord insertion in our study. A larger sample size of women conceived using ART would be needed to fully understand the effect of ART on abnormal placental cord insertion beyond the confounding effect of multiple gestations.