Maternal and Fetal Outcomes in Pregnancies Conceived after Assisted Reproductive Techniques in a Tertiary Care Center of Western Gujarat

Authors

  • Hitendrasinh Balvantsinh Jadeja Assistant Professor, Government Medical College, Bhavnagar, Gujarat, India
  • Taxashil H. Jadeja MBBS, NHL Medical College, Ahmedabad, Gujarat, India
  • Satwani Dhananjay Dwarkadas Junior resident, Zydus Foundation Medical College & Zydus Medical College and Hospital, Dahod, Gujarat, India

Abstract

Background: Assisted reproductive techniques (ART) have revolutionized infertility treatment, enabling many couples to achieve pregnancy. However, concerns persist regarding the safety of ART pregnancies, particularly in terms of maternal and fetal outcomes. This study evaluates maternal and fetal outcomes in ART-conceived pregnancies compared to spontaneously conceived pregnancies in a tertiary care center in Western Gujarat, India. Material and Methods: A retrospective cohort study was conducted at a tertiary care center in Western Gujarat for a period of 2 years, including 250 ART-conceived pregnancies and 500 age-matched spontaneously conceived pregnancies. Maternal outcomes assessed included gestational diabetes mellitus (GDM), hypertensive disorders, preterm birth, and cesarean section rates. Fetal outcomes included gestational age, birth weight, Apgar scores, and congenital anomalies. Logistic regression and t-tests were used to compare outcomes, adjusting for confounders like maternal age and parity. Results: ART pregnancies showed a higher incidence of GDM (OR 1.8, 95% CI 1.2–2.7), hypertensive disorders (OR 1.6, 95% CI 1.1-2.4), preterm birth (OR 1.5, 95% CI 1.0–2.2), and cesarean delivery (OR 2.0, 95% CI 1.4-2.9) compared to spontaneous pregnancies. Fetuses from ART pregnancies had lower mean gestational age (37.2 vs. 38.5 weeks, p=0.001) and birth weight (2.8 vs. 3.1 kg, p=0.002). Multiple pregnancies (25% in ART vs. 5% in controls) significantly mediated these outcomes. Congenital anomalies were slightly higher in ART (3.2% vs. 2.0%, p=0.08). Conclusion: The increased risks in ART pregnancies, particularly for GDM and preterm birth, align with global and Indian studies, likely due to multiple pregnancies and maternal factors. ART pregnancies in Western Gujarat exhibit higher maternal and fetal complications compared to spontaneous pregnancies, primarily driven by multiple gestations. Enhanced prenatal care is warranted to optimize outcomes.

Keywords:

Assisted Reproductive Techniques, Maternal Outcomes, Fetal Outcomes, Gujarat, Pregnancy Complications

References

1. Boczar A, Dryja P, Jarmołowicz J, Stawicka I, Orzołek I, Solisch S. A comparison of the ef-fectiveness of different assisted reproductive techniques (ART) in couples with unexplained infertility. J Educ Health Sport. 2024;71:56073-56073.

2. Sarojini N, Marwah V, Shenoi A. Globalisa-tion of birth markets: a case study of assisted reproductive technologies in India. Glob Health. 2011;7(1):27.

3. Aleyamma T, Kamath MS, Muthukumar K, Mangalaraj AM, George K. Affordable ART: a different perspective. Hum Reprod. 2011;26(12):3312-8.

4. Kibret KT, Chojenta C, Gresham E, Tegegne TK, Loxton D. Maternal dietary patterns and risk of adverse pregnancy (hypertensive disor-ders of pregnancy and gestational diabetes mellitus) and birth (preterm birth and low birth weight) outcomes: a systematic review and meta-analysis. Public Health Nutr. 2019;22(3):506-20.

5. Jackson S, Hong C, Wang ET, Alexander C, Gregory KD, Pisarska MD. Pregnancy out-comes in very advanced maternal age pregnan-cies: the impact of assisted reproductive tech-nology. Fertil Steril. 2015;103(1):76–80.

6. Lean SC, Derricott H, Jones RL, Heazell AE. Advanced maternal age and adverse pregnancy outcomes: A systematic review and meta-analysis. PloS One. 2017;12(10):e0186287.

7. Huang JYJ, Rosenwaks Z. Assisted reproduc-tive techniques. In: Human fertility: methods and protocols. Springer; 2014. p. 171–231.

8. Valvi D, Swaminathan G. Maternal and peri-natal outcome following assisted reproductive technology in a tertiary care centre: a retro-spective study. Int J Reprod Contracept Obstet Gynecol. 2019;8(5):1745–51.

9. Tai W, Hu L, Wen J. Maternal and neonatal outcomes after assisted reproductive technolo-gy: a retrospective cohort study in China. Front Med. 2022;9:837762.

10. Ruchi Kumari, Anubhuti Patel, Kabita Chana-nia. Obstetric and perinatal outcomes of preg-nancies Following Assisted Reproductive Techniques In a Tertiary Care Center Com-pared with Age Matched Control Conceived Spontaneously. J Neonatal Surg. 2025;14(12): 400-7.

11. Da Silva SG, da Silveira MF, Bertoldi AD, Domingues MR, Dos Santos I da S. Maternal and child-health outcomes in pregnancies fol-lowing Assisted Reproductive Technology (ART): a prospective cohort study. BMC Pregnancy Childbirth. 2020; 20(1):106.

12. Marleen S, Kodithuwakku W, Nandasena R, Mohideen S, Allotey J, Fernández-García S, et al. Maternal and perinatal outcomes in twin pregnancies following assisted reproduction: a systematic review and meta-analysis involving 802 462 pregnancies. Hum Reprod Update. 2024; 30(3):309-22.

13. Nouri K, Ott J, Stoegbauer L, Pietrowski D, Frantal S, Walch K. Obstetric and perinatal outcomes in IVF versus ICSI-conceived preg-nancies at a tertiary care center-a pilot study. Reprod Biol Endocrinol. 2013; 11(1):84.

Published

2025-08-26
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Issue

Vol. 16 No. 9 (2025): Volume16,Issue9

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Articles