Features of pregnancy, delivery and postpartum on the background of assisted reproductive technologies

The objective: to establish the characteristics of the course of pregnancy and childbirth after the use of assisted reproductive technologies (ART); to stratify the risks in this contingent of pregnant women, to determine the high-risk subgroup among pregnant women after the use of ART and the formation of possible preventive approaches for these categories of patients. Materials and methods. A retrospective analysis of 3450 histories of pregnancy and childbirth that occurred during 2018–2020, was carried out. Inclusion criteria: first singleton delivery in cephalic presentation without critical congenital malformations in the fetus and severe somatic pathologies in pregnant women aged 18–45 years. Two groups were formed: a group with spontaneous pregnancy (3137 histories) and a group with pregnancy after ART (313 histories), which, according to the age factor, were divided into subgroups of active (2686 and 159 histories, respectively) and late reproductive age (451 and 154 histories, respectively). For statistical analysis, odds ratio (OR) and 95% confidence interval (CI) were calculated. The χ-square test was used to assess the significance of the difference in proportions. The level of statistical significance was at p<0.05. Results. The frequency of normal births in the subgroup of late reproductive age with pregnancy after the use of ART was 38.8%, that almost 2 times lower than in the subgroup of spontaneous pregnancy in women of late reproductive age (65.5%; p<0.05). Patients with late reproductive age and pregnancy after using ART (28.5%) had two times higher chances of induction of labor compared with the spontaneous pregnancy subgroup (14.3%; p<0.05). The incidence of cesarean section was 51.1% in the ART subgroup compared to 27% in the spontaneous pregnancy subgroup (p<0.05). In the subgroup of late reproductive age and pregnancy after ART, the probability of cesarean section was in 1.7 times higher than in the subgroup of active reproductive age and pregnancy after ART. The risks of developing massive obstetric bleeding in patients with late reproductive age and pregnancy after ART were in 5.5 times higher than in patients with spontaneous pregnancy (p