perinatal outcomes of pregnancies conceived by assisted reproductive technologies

Introduction. Recent epidemiological studies showed significantly higher incidence of perinatal complications in newborns and women after the use of assisted reproductive technologies (ART). Multiple pregnancies are more frequent after the use of ART. Singleton pregnancies following ART are more prone to preterm birth, low and very low birth weight (LBW and VLBW), small for gestational age (SGA) and perinatal mortality. Objective. The aim of this study was to summarize the results of relevant articles and to evaluate whether the mode of conception is the determining factor for different pregnancy outcomes after assisted and natural conceptions. Methods. Eleven studies were included in this review. The following outcomes were observed: preterm and very preterm birth, SGA, LBW, VLBW, perinatal mortality, admission to neonatal intensive care unit (NICU), and Apgar score (As) ≤7 at fifth minute. Qualitative analysis and quantitative assessment were performed. Results. For singletons, odds ratios were 1.794 (95% confidence interval 1.660-1.939) for preterm birth, 1.649 (1.301-2.089) for LBW, 1.265 (1.048-1.527) for SGA. Admission to NICU, As≤7 at fifth minute and perinatal mortality showed significantly different frequency after assisted conception. Summary of results for twin gestations showed no significant difference between ART and spontaneous conception for preterm birth (32-36 weeks), very preterm birth (<32 weeks), LBW and VLBW. Conclusion. Analyzed studies showed that infants from ART have significantly worse perinatal outcome compared with natural conception. More observational studies should be conducted in order to establish the exact mechanism leading to more frequent perinatal morbidity and mortality after the use of ART.