Research question

To evaluate pre-existing comorbidities, obstetric risk factors and adverse obstetric and neonatal outcomes in pregnancies conceived by oocyte donation, compared with naturally conceived pregnancies or by conventional IVF/intracytoplasmic sperm injection (IVF/ICSI).

Design

This retrospective single-centre contemporary cohort study reviewed data from singleton deliveries at the University Hospital of Careggi, Florence, from 2009 to 2017. Maternal and perinatal outcomes were analysed.

Results

The study included 25,851 pregnancies and newborns: 276 (1.1%) children were conceived after oocyte donation, 925 (3.6%) after IVF/ICSI and 24,650 (95.4%) after natural conception. Women in the oocyte donation group were significantly older compared with IVF/ICSI and natural conception groups (P < 0.0001) and had a higher prevalence of chronic hypertension compared with the natural conception group (P = 0.0090). They were administered anticoagulant medications more frequently during pregnancy. The incidence of gestational hypertension was significantly higher than in natural conception (aOR 3.6) and IVF/ICSI pregnancies (aOR 2.7). The incidence of Caesarean section in oocyte donation pregnancies was higher than in natural conception and IVF/ICSI groups (aOR 3.4 and 2.3, respectively). An 11-fold increased risk of post-partum haemorrhage (PPH) was found in oocyte donation versus natural conception and an almost four-fold increased risk was found in oocyte donation versus IVF/ICSI; prematurity and low birthweight were more frequent after oocyte donation versus natural conception (aOR 2.4 and 1.8, respectively).

Conclusions

Patients undergoing oocyte donation represent a group with increased comorbidities and risk factors for adverse obstetric outcomes. Oocyte donation seems to be independently associated with gestational hypertension and PPH. Pregnancies after oocyte donation warrant clinical surveillance with proper screening and, possibly, preventive strategies.

中文翻译：

---

卵母细胞捐赠妊娠中的合并症，危险因素和母婴围产期结局。

研究问题

与自然怀孕或常规IVF /胞浆内精子注射（IVF / ICSI）相比，通过捐赠卵母细胞来评估妊娠中合并症，产科危险因素以及不良的产科和新生儿结局。

设计

这项回顾性单中心当代队列研究回顾了2009年至2017年在佛罗伦萨卡格吉大学医院单胎分娩的数据。分析了母体和围产期结局。

结果

该研究包括25,851例怀孕和新生儿：捐赠卵母细胞后妊娠276（1.1％）名儿童，IVF / ICSI妊娠后925（3.6％）名，自然受孕后24,650（95.4％）名。与IVF / ICSI和自然受孕组相比，卵母细胞捐献组中的妇女年龄要大得多（P  <0.0001），与自然受孕组相比，慢性高血压的患病率更高（P = 0.0090）。他们在怀孕期间更频繁地服用抗凝药物。妊娠高血压的发生率明显高于自然受孕（aOR 3.6）和IVF / ICSI妊娠（aOR 2.7）。卵子捐献妊娠中剖腹产的发生率高于自然受孕和IVF / ICSI组（分别为aOR 3.4和2.3）。与自然受孕相比，卵母细胞捐赠的产后出血（PPH）风险增加了11倍，与IVF / ICSI相比，卵母细胞捐赠的风险增加了近四倍。卵母细胞捐赠后早产和低出生体重较自然受孕更为频繁（分别为aOR 2.4和1.8）。

结论

接受卵母细胞捐赠的患者代表了合并症和产科不良预后的危险因素增加的人群。卵母细胞捐赠似乎与妊娠高血压和PPH独立相关。卵母细胞捐赠后的怀孕需要进行适当的筛查和可能的预防策略进行临床监测。