Pregnancy Outcomes Following Assisted Reproductive Technology in Advanced Maternal Age Primiparous Women: A Retrospective Cohort Study

作者：Qi Deng, Ting Ji, Guanghua Chu, Hongwei Tan · 发表于：International Journal of Women s Health · 年份：2025 · DOI：10.2147/ijwh.s538128 · 被引用次数：4 · 研究领域：Assisted Reproductive Technology and Twin Pregnancy、Reproductive Health and Technologies、Ovarian function and disorders

Purpose: To evaluate maternal and neonatal outcomes following assisted reproductive technology (ART) in advanced maternal age (AMA) primiparous women. Patients and Methods: This retrospective cohort study analyzed 2329 AMA primiparous women (≥35 years) who delivered singleton pregnancies at Northwest Women's and Children's Hospital between January 2016 and January 2020. Participants were stratified into ART (n=422) and spontaneous conception (SC, n=1907) groups. Maternal characteristics, obstetric complications, and neonatal outcomes were compared using multivariate logistic regression to adjust for confounders. Results: ART patients exhibited significantly higher maternal age (37.48 ± 2.44 vs 36.65 ± 1.90 years, *p* < 0.001) and BMI (27.79 ± 3.34 vs 27.61 ± 8.12 kg/m², *p* = 0.016). ART was independently associated with increased risks of preeclampsia (adjusted odds ratio [aOR] 1.89, 95% confidence interval [CI] 1.25-2.86), cesarean delivery (aOR 2.31, 95% CI 1.74-3.06), preterm birth (aOR 1.55, 95% CI 1.10-2.19), and neonatal intensive care unit (NICU) admission (aOR 2.38, 95% CI 1.68-3.37). Conversely, SC pregnancies showed higher rates of preterm premature rupture of membranes (PPROM; 26.43% vs 17.30%, *p* < 0.001). No significant differences were observed in gestational diabetes mellitus (33.18% vs 31.31%, *p* = 0.455) or placental abruption (0.95% vs 1.42%, *p* = 0.313). Conclusion: In AMA primiparas, ART selectively elevates risks of preeclampsia and neonatal morbidity...