OBJECTIVE To evaluate the association between in vitro fertilization (IVF) and ischemic placental disease (IPD), stratified by gestational age. DESIGN We performed a secondary analysis of a retrospective cohort study of deliveries. SETTING Deliveries were performed over 15 years at a single tertiary hospital. PATIENT(S) We included all parturients who had a live born infant or an intrauterine fetal demise (IUFD). INTERVENTION(S) We compared pregnancies resulting from IVF cycles to non-IVF pregnancies. MAIN OUTCOME MEASURE(S) The primary outcomes were preterm and term IPD (preeclampsia, placental abruption, small-for-gestational age infant [SGA], or an intrauterine fetal demise [IUFD] due to placental insufficiency). RESULT(S) Of the 69,084 deliveries during the study period, 3,763 (5.4%) were conceived with IVF. The incidence of preterm delivery was 32.6% in IVF pregnancies and 10.8% in non-IVF pregnancies. Multiple gestations were more common in IVF pregnancies. Compared to non-IVF pregnancies, IVF pregnancies were more likely to develop both preterm and term IPD, even after adjustment for maternal age and parity. The risk of preterm IPD was 4 times higher (95% confidence interval, 3.7-4.4) in patients who underwent IVF compared with those who did not undergo IVF. Among parturients who delivered at ≥37 weeks of gestation, IVF pregnancies had 1.7 times the risk of term IPD (95% confidence interval, 1.6-1.9) compared with non-IVF pregnancies. CONCLUSION(S) IVF was strongly associated with preterm IPD. We found a similar, but attenuated, association between IVF and term IPD. The stronger association with preterm IPD suggests an association between IVF and placental insufficiency.

中文翻译：

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不同胎龄体外受精与缺血性胎盘疾病的相关性

目的 评估体外受精 (IVF) 与缺血性胎盘疾病 (IPD) 之间的关联，按胎龄分层。设计 我们对分娩的回顾性队列研究进行了二次分析。地点 在一家三级医院进行了超过 15 年的分娩。患者 我们纳入了所有有活产婴儿或宫内胎儿死亡 (IUFD) 的产妇。干预措施 我们比较了 IVF 周期导致的妊娠与非 IVF 妊娠。主要结局指标 主要结局是早产和足月 IPD（先兆子痫、胎盘早剥、小于胎龄儿 [SGA] 或由于胎盘功能不全导致的宫内胎儿死亡 [IUFD]）。结果 在研究期间的 69,084 次分娩中，3,763 (5.4%) 次是通过 IVF 受孕的。早产的发生率在 IVF 妊娠中为 32.6%，在非 IVF 妊娠中为 10.8%。多胎妊娠在 IVF 妊娠中更为常见。与非 IVF 妊娠相比，IVF 妊娠更可能发生早产和足月 IPD，即使在调整了母亲的年龄和产次后也是如此。与未接受 IVF 的患者相比，接受 IVF 的患者发生早产 IPD 的风险高 4 倍（95% 置信区间，3.7-4.4）。在妊娠≥ 37 周分娩的产妇中，IVF 妊娠的足月 IPD 风险是非 IVF 妊娠的 1.7 倍（95% 置信区间，1.6-1.9）。结论 (S) IVF 与早产 IPD 密切相关。我们发现 IVF 与足月 IPD 之间存在类似但减弱的关联。