Objective

Multifetal gestation is more frequent among gestational carrier pregnancies than non-surrogacy IVF pregnancies. We aimed to evaluate the association between multifetal gestation and obstetric and neonatal morbidity among gestational carrier pregnancies.

Methods

Pooled cross-sectional study of birth certificate data from gestational carrier pregnancies in Utah from 2009 to 2018. Our primary outcome was a composite of severe obstetric morbidity; secondary outcomes included cesarean delivery (CD), hypertensive disorders of pregnancy, preterm birth (PTB), and a neonatal morbidity composite. Logistic regression was utilized to compare odds of these outcomes between gestational carrier pregnancies with and without multifetal gestation.

Results

A total of 361 gestational carrier pregnancies resulted in the delivery of 435 neonates during the study period. Of these, 284 were singleton pregnancies, and 77 were multifetal, a multifetal gestation rate of 21.3%. Baseline demographic characteristics did not differ between singleton and multifetal gestations. Multifetal gestation was not associated with higher rates of severe obstetric morbidity (odds ratio [OR] 1.87, 95% confidence interval [CI] 0.34–10.39). Multifetal gestation was associated with increased odds of neonatal morbidity (OR 9.49, 95% CI 5.35–15.83); PTB < 37, 34, and 32 weeks (OR 21.88, 95% CI 11.64–41.12; OR 11.67, 95% CI 5.25–25.91; OR 8.79, 95% CI 3.41–22.68); and CD (OR 4.82, 95% CI 2.81–8.27).

Conclusion

Severe obstetric morbidity did not differ between singleton and multifetal gestations among gestational carrier pregnancies. However, multifetal gestation was associated with increased odds of neonatal morbidity, CD, and PTB. This information may be useful when counseling prospective gestational carriers and intended parents.

中文翻译：

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妊娠携带者妊娠中多胎妊娠与产科和新生儿结局的关系

 客观的

与非代孕 IVF 妊娠相比，妊娠携带者妊娠中多胎妊娠更为常见。我们的目的是评估多胎妊娠与妊娠携带者妊娠中产科和新生儿发病率之间的关联。

 方法

对 2009 年至 2018 年犹他州妊娠携带者妊娠的出生证明数据进行汇总横断面研究。我们的主要结果是严重产科发病率的综合结果；次要结局包括剖宫产（CD）、妊娠期高血压疾病、早产（PTB）和新生儿发病率综合。使用逻辑回归来比较有和没有多胎妊娠的妊娠携带者妊娠之间这些结果的几率。

 结果

研究期间，共有 361 名代孕者妊娠并分娩了 435 名新生儿。其中，单胎妊娠284例，多胎妊娠77例，多胎妊娠率为21.3%。单胎妊娠和多胎妊娠之间的基线人口统计学特征没有差异。多胎妊娠与较高的严重产科发病率无关（比值比 [OR] 1.87，95% 置信区间 [CI] 0.34–10.39）。多胎妊娠与新生儿发病率增加相关（OR 9.49，95% CI 5.35–15.83）； PTB < 37、34 和 32 周（OR 21.88，95% CI 11.64–41.12；OR 11.67，95% CI 5.25–25.91；OR 8.79，95% CI 3.41–22.68）；和 CD（OR 4.82，95% CI 2.81–8.27）。

 结论

妊娠携带者妊娠中单胎和多胎妊娠的严重产科发病率没有差异。然而，多胎妊娠与新生儿发病率、CD 和 PTB 的几率增加相关。在为未来的代孕人和预期父母提供咨询时，这些信息可能会很有用。