Perinatal outcomes among singletons after assisted reproductive technology versus from natural pregnancy

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This study was performed to compare perinatal outcomes and placental efficiency of singleton conceived from ART with spontaneous pregnancy. Retrospective cohort study. In this retrospective cohort study which was performed in the Third Affiliated Hospital of Zhengzhou University, 3991 singleton conceived from ART and spontaneous pregnancy were enrolled: ART group (n=1004) and spontaneous pregnancy group (n=2987). Baseline data and perinatal outcomes information including demographic data, gestational age, mode of delivery, pregnancy complications, preterm labor, and intrauterine growth retardation (IUGR), postpartum hemorrhage, neonatal outcomes (weight, Apgar score, severe asphyxia mobidity, incidence rate of birth defect, neonatal mortality) were recorded. Moreover, the age-stratified analysis was performed. Gestational age, cesarean section, premature rupture and placenta previa were significantly higher in ART group compared to spontaneous pregnancy group(P <0.05). However, there were no significant differences between groups in terms of other factors such as hypertensive disorder during pregnancy, abnormal glucose metabolism, gestational cholestasis, pregnancy with thyroid dysfunction, pregnancy with anemia, group B streptococcal infection and postpartum hemorrhage and other pregnancy complications (P>0.05). For neonatal outcomes, severe asphyxia mobidity was higher in the ART group (7.7%) than spontaneous pregnancy group (2.4%). Compared with the spontaneous pregnancy group, placental weight was higher and placental efficiency was lower in ART group (all P<0.05). Moreover, age-stratified analysis: in the group of age<35, the average birth weight, low birth weight rate, neonatal severe asphyxia rate, placental weight and placental efficiency were significant higher in the ART group (all P<0.05). However, in the group of age≥35, there were no differences between groups (P>0.05). The perinatal outcomes among singletons following ART is relatively safe, although ART affects placental efficiency. In elder group, age has a predominant effect on perinatal outcome.