Comparative Analysis Perinatal Complications Among Women with ART-Induced Pregnancy and Natural Conception

Abstract

Objective: This study conducted a retrospective matched analysis to explore the differences and potential associations in perinatal complications between pregnancies achieved through in-vitro fertilization-embryo transfer (IVF-ET) and natural conception. Methods: A total of 806 pregnant women who delivered at the Department of Obstetrics, First Hospital of Lanzhou University, China, from January 2019 to August 2024 were included, with 403 cases in the experimental group and 403 matched controls (natural conception) based on admission month and gestational age (±7 days). Results: Analysis revealed that the experimental group exhibited significantly higher incidences of multiple gestations, anemia, postpartum hemorrhage, gestational hypertension, gestational diabetes mellitus, and intrahepatic cholestasis of pregnancy compared to the control group. In singleton pregnancy analysis, these differences persisted except for pelvic inflammation. The findings suggest that ART pregnancies may increase perinatal risks through factors such as embryo manipulation, hormonal interventions, and underlying maternal pathologies. Conclusion: This matched retrospective study highlights that IVF-ET pregnancies are associated with significantly higher risks of multiple gestations and obstetric complications, independent of multifetal pregnancies. The findings underscore the necessity of optimizing embryo transfer strategies, such as promoting single embryo transfer and implementing enhanced monitoring protocols for high-risk complications in resource-limited settings like Northwest China. This study provides regional evidence to support the development of tailored ART guidelines.