Association between fertility treatments and early placentation markers.
Placenta
; 82: 35-41, 2019 07.
Article
em En
| MEDLINE
| ID: mdl-31174624
ABSTRACT
INTRODUCTION:
Pregnancies resulting from fertility treatments are at higher risk of placenta-mediated complications. Hence, we aimed to estimate the association between fertility treatment and levels of first-trimester markers of placentation.METHODS:
We conducted a cohort study in an academic center from 03/2011 to 12/2014. Adult nulliparous women with singleton pregnancies were recruited between 11 + 0 and 13 + 6 weeks of gestation. Data on maternal characteristics, medical history, and pregnancies conceived through fertility treatments (whether ovulation agents, insemination or assisted reproductive technologies) were collected. Maternal serum concentrations of PlGF, sFlt-1, PAPP-A, AFP, and free ß-hCG were obtained, and notches and UtA-PI were measured using Doppler ultrasound. Mean Multiple of the Medians (MoM) and frequencies were computed to estimate the mean differences (MD) or risk ratios (RR) comparing fertility treatment to spontaneous pregnancies.RESULTS:
427 (9%) pregnancies out of 4815 were conceived through fertility treatments, using ovulation agents (nâ¯=â¯233, 5%), insemination (nâ¯=â¯174, 4%) and/or assisted reproductive technologies (nâ¯=â¯85, 2%). The latter were associated with significantly lower log10PAPP-A MoM (adjusted MD -0.02, 95%CI -0.04 to -0.01), lower log10PlGF MoM (adjusted MD -0.04, 95%CI -0.06 to -0.01) and higher log10free ß-hCG MoM (adjusted MD 0.05, 95%CI 0.01 to 0.09) compared to spontaneous pregnancies. Ovulation agents and insemination were associated with the presence of notches (adjusted RR 1.24, 95%CI 1.14 to 1.35; and 1.27, 95%CI 1.15 to 1.42, respectively) and higher log10UtA-PI MoM (adjusted MD 0.16, 95%CI 0.08 to 0.24; and 0.17, 95%CI 0.07 to 0.27, respectively) than spontaneous pregnancies.CONCLUSION:
Fertility treatments are associated with significant variations in markers of placentation.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Placentação
/
Proteína Plasmática A Associada à Gravidez
/
Gonadotropina Coriônica Humana Subunidade beta
/
Técnicas de Reprodução Assistida
/
Fator de Crescimento Placentário
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Pregnancy
Idioma:
En
Revista:
Placenta
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Canadá