Research question

What are the clinical characteristics of pregnancies complicated by fetal growth restriction (FGR) and preeclampsia in patients who have undergone IVF, and what is the correlation between these complications and histopathological placental findings in such pregnancies.

Design

A retrospective cohort of patients who had delivered their babies at our institution who had been diagnosed with preeclampsia, whose babies had been diagnosed with FGR, or both. Deliveries in which the placenta was sent for histopathological examination were included. Computerized files and pathological reports were reviewed, and maternal, obstetric, neonatal outcomes and placental histopathological reports were compared between pregnancies conceived by IVF and controls. Placental lesions were classified according to the Amsterdam criteria.

Results

Between December 2008 and December 2018, the placentas of 1114 singleton babies who had received a diagnosis of FGR, whose mothers had received a diagnosis of preeclampisa, or both, were examined. A total of 105 patients conceived with IVF and 1009 were conceived spontaneously. The IVF group was older, of lower parity and had a higher rate of diabetes and chronic hypertension. Deliveries occurred at an earlier gestational age, although birth weight was not significantly different between the groups. The rate of neonatal adverse composite outcome among IVF deliveries was significantly lower (59.0% versus 76.7%; P < 0.001). On placental examination, placental weight, maternal and fetal vascular malperfusion lesions were similar between the groups, whereas villitis of unknown etiology was significantly more common among the IVF group (16.2% versus 8.3%; P = 0.007).

Conclusion

Neonatal outcome is relatively favourable in IVF patients with placental-related diseases. Placental chronic villitis is more common in IVF patients, pointing to an additive immunological cause.

中文翻译：

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胎盘相关的妊娠障碍和试管婴儿：胎盘组织学检查是否可以解释过度风险？

研究问题

接受IVF的孕妇并发胎儿生长受限（FGR）和先兆子痫的临床特征是什么，这些并发症与这些妊娠的组织病理学胎盘发现之间有什么相关性。

设计

回顾性队列分析了在我们机构分娩的婴儿患者，这些患者被诊断患有先兆子痫，或婴儿被诊断出患有FGR。包括将胎盘送去进行组织病理学检查的分娩。审查了计算机文件和病理报告，并比较了IVF怀孕和对照组的孕妇，产科，新生儿结局和胎盘组织病理学报告。胎盘病变根据阿姆斯特丹标准分类。

结果

在2008年12月至2018年12月之间，检查了1114名单胎婴儿的胎盘，这些单胎婴儿被诊断为FGR，其母亲被诊断为先兆子痫，或两者均被诊断。自然孕育了105例IVF患者和1009例。试管婴儿组年龄较大，胎次较低，糖尿病和慢性高血压的发生率较高。分娩发生在较早的胎龄，尽管两组之间的出生体重没有显着差异。IVF分娩中新生儿不良复合结局发生率显着降低（59.0％对76.7％；P<0.001）。在胎盘检查中，两组之间的胎盘重量，母体和胎儿血管灌注不良病变相似，而IVF组中病因不明的绒毛炎更为常见（16.2％对8.3％；P = 0.007）。

结论

IVF胎盘相关疾病患者的新生儿结局相对较好。胎盘慢性绒毛膜炎在IVF患者中更为常见，表明存在附加的免疫学原因。