Adverse obstetric outcomes in pregnancies resulting from oocyte donation: a retrospective cohort case study in Sweden

BMC Pregnancy and Childbirth

Gunilla Sydsjö¹  Helena Åkerud²  Alkistis Skalkidou²  Claudia Lampic³  Agneta Skoog Svanberg²  Evangelia Elenis² 

[1] Obstetrics and Gynaecology, Department of Clinical Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden;Department of Women’s and Children’s Health, Uppsala University, Uppsala University Hospital, Uppsala SE-751 83, Sweden;Department of Neurobiology, Care sciences and Society, Karolinska Institutet, Solna, Sweden

关键词: Pregnancy complications;    Oocyte donation;    Indication for oocyte donation;    Hypertensive disorders;   

Others  :  1228385
DOI  :  10.1186/s12884-015-0687-9

 received in 2015-04-20, accepted in 2015-10-04,  发布年份 2015

【 摘 要 】

Background

Oocyte donation has been associated to gestational diabetes, hypertensive disorders, placental abnormalities, preterm delivery and increased rate of caesarean delivery while simultaneously being characterized by high rates of primiparity, advanced maternal age and multiple gestation constituting the individual risk of mode of conception difficult to assess. This study aims to explore obstetrical outcomes among relatively young women with optimal health status conceiving singletons with donated versus autologous oocytes (via IVF and spontaneously).

Methods

National retrospective cohort case study involving 76 women conceiving with donated oocytes, 150 nulliparous women without infertility conceiving spontaneously and 63 women conceiving after non-donor IVF. Data on obstetric outcomes were retrieved from the National Birth Medical Register and the medical records of oocyte recipients from the treating University Hospitals of Sweden. Demographic and logistic regression analysis were performed to examine the association of mode of conception and obstetric outcomes.

Results

Women conceiving with donated oocytes (OD) had a higher risk of hypertensive disorders [adjusted Odds Ratio (aOR) 2.84, 95 % CI (1.04–7.81)], oligohydramnios [aOR 12.74, 95 % CI (1.24–130.49)], postpartum hemorrhage [aOR 7.11, 95 % CI (2.02–24.97)] and retained placenta [aOR 6.71, 95 % CI (1.58–28.40)] when compared to women who conceived spontaneously, after adjusting for relevant covariates. Similar trends, though not statistically significant, were noted when comparing OD pregnant women to women who had undergone non-donor IVF. Caesarean delivery [aOR 2.95, 95 % CI (1.52–5.71); aOR 5.20, 95 % CI (2.21–12.22)] and induction of labor [aOR 3.00, 95 % CI (1.39–6.44); aOR 2.80, 95 % CI (1.10–7.08)] occurred more frequently in the OD group, compared to the group conceiving spontaneously and through IVF respectively. No differences in gestational length were noted between the groups. With regard to the indication of OD treatment, higher intervention was observed in women with diminished ovarian reserve but the risk for hypertensive disorders did not differ after adjustment.

Conclusion

The selection process of recipients for medically indicated oocyte donation treatment in Sweden seems to be effective in excluding women with severe comorbidities. Nevertheless, oocyte recipients-despite being relatively young and of optimal health status- need careful counseling preconceptionally and closer monitoring prenatally for the development of hypertensive disorders.

【 授权许可】

   
2015 Elenis et al.

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