Increased Risks of Placental Abruption and Preterm Delivery in ART Patients, unravels JAMA study

The patients using assisted reproductive technology (ART) may require additional counseling due to the elevated risks of placental abruption and preterm delivery associated with ART. A recent study published in the Journal of American Medical Association unveiled the need for further investigation into the compounded risk of the complications associated with ART pregnancies.

The study assessed the risk of placental abruption in patients who conceived with ART and evaluated whether the combination of placental abruption and ART conception increase the risk of preterm delivery beyond the individual risk associated. This research utilized data from the National Inpatient Sample after encompassing hospital inpatient discharges from over 48 states across the U.S. The participant pool included women from 15 to 54 years who gave birth between 2000 and 2019. The analysis was performed from January to April 2024. The study involved a total of 7,89,01,058 deliveries, with a mean maternal age of 27.9 years. The demographic included 11.7% Black individuals, 18.9% Hispanic individuals, 44.2% White individuals and 25.2% from other races and ethnicities. Also, 98.2% of the deliveries were singleton pregnancies, 68.8% were vaginal deliveries and 52.1% were covered by private insurance.

The risk of placental abruption was found to be higher in ART pregnancies when comparing spontaneous conceptions to ART conceptions. After adjusting for confounders, the adjusted odds ratio (AOR) for placental abruption in ART pregnancies was 1.42, with a 95% confidence interval (CI) of 1.34-1.51. This risk was markedly higher in White women when compared Black women.

The likelihood of preterm delivery was also significantly higher in ART pregnancies when compared to spontaneous conceptions, with an AOR of 1.46 (95% CI, 1.42-1.51). Also, the study illuminated a synergistic increase in the risk of preterm delivery when both ART conception and placental abruption were present, with a relative excess risk due to interaction (RERI) of 2.0 (95% CI, 0.5-3.5).

The findings of this study found significant implications for counseling patients who seek infertility treatment. While ART provides a positive path for parenthood in many individuals, it is critical to recognize and address the associated risks. Further research and comprehensive studies are needed to explore the mechanisms behind these risks and to develop inclusive guidelines for managing the pregnancies conceived through ART.

Source:

Zhang, J. T., Lee, R., Sauer, M. V., & Ananth, C. V. (2024). Risks of Placental Abruption and Preterm Delivery in Patients Undergoing Assisted Reproduction. In JAMA Network Open (Vol. 7, Issue 7, p. e2420970). American Medical Association (AMA). https://doi.org/10.1001/jamanetworkopen.2024.20970