TY - JOUR
T1 - Maternal and neonatal outcomes associated with trophectoderm biopsy
AU - Zhang, Wendy Y.
AU - von Versen-Höynck, Frauke
AU - Kapphahn, Kristopher I.
AU - Fleischmann, Raquel R.
AU - Zhao, Qianying
AU - Baker, Valerie L.
N1 - Funding Information:
Funded by award no. P01 HD 065647-01A1 from the National Institute of Child and Human Development (to V.L.B.), a Heisenberg Fellowship Award from the German Research Foundation (VE490/8-1; to F.v.V.-H.), and a MedScholars fellowship from the Stanford Medical Scholars Research Program (to W.Y.Z.). The use of REDCap was supported by a Stanford Clinical and Translational Science Award no. UL1 TR001085 from the National Institutes of Health National Center for Research Resources.
Funding Information:
Funded by award no. P01 HD 065647-01A1 from the National Institute of Child and Human Development (to V.L.B.), a Heisenberg Fellowship Award from the German Research Foundation (VE490/8-1; to F.v.V.-H.), and a MedScholars fellowship from the Stanford Medical Scholars Research Program (to W.Y.Z.). The use of REDCap was supported by a Stanford Clinical and Translational Science Award no. UL1 TR001085 from the National Institutes of Health National Center for Research Resources. Funded by award no. P01 HD 065647-01A1 from the National Institute of Child and Human Development (to V.L.B.), a Heisenberg Fellowship Award from the German Research Foundation (VE490/8-1; to F.v.V.-H.), and a MedScholars fellowship from the Stanford Medical Scholars Research Program (to W.Y.Z.). The use of REDCap was supported by a Stanford Clinical and Translational Science Award no. UL1 TR001085 from the National Institutes of Health National Center for Research Resources. The authors would like to thank all participants and hospitals that supported the collection of these data. Funded by award no. P01 HD 065647-01A1 from the National Institute of Child and Human Development (to V.L.B.), a Heisenberg Fellowship Award from the German Research Foundation (VE490/8-1; to F.v.V.-H.), and a MedScholars fellowship from the Stanford Medical Scholars Research Program (to W.Y.Z.). The use of REDCap was supported by a Stanford Clinical and Translational Science Award no. UL1 TR001085 from the National Institutes of Health National Center for Research Resources.
Publisher Copyright:
© 2019 American Society for Reproductive Medicine
PY - 2019/8
Y1 - 2019/8
N2 - Objective: To assess whether pregnancies achieved with trophectoderm biopsy for preimplantation genetic testing (PGT) have different risks of adverse obstetric and neonatal outcomes compared with pregnancies achieved with IVF without biopsy. Design: Observational cohort. Setting: University-affiliated fertility center. Patient(s): Pregnancies achieved via IVF with PGT (n = 177) and IVF without PGT (n = 180) that resulted in a live birth. Intervention(s): None. Main Outcome Measure(s): Maternal outcomes including preeclampsia and placenta previa and neonatal outcomes including birth weight and birth defects. Result(s): There was a statistically significant increase in the risk of preeclampsia among IVF+PGT pregnancies compared with IVF without PGT pregnancies, with an incidence of 10.5% versus 4.1% (adjusted odds ratio [aOR] = 3.02; 95% confidence interval [95% CI], 1.10, 8.29). The incidence of placenta previa was 5.8% in IVF+PGT pregnancies versus 1.4% in IVF without PGT pregnancies (aOR = 4.56; 95% CI, 0.93, 22.44). Similar incidences of gestational diabetes, preterm premature rupture of membranes, and postpartum hemorrhage were observed. IVF+PGT and IVF without PGT neonates did not have a significantly different gestational age at delivery or rate of preterm birth, low birth weight, neonatal intensive care unit admission, neonatal morbidities, or birth defects. All trends, including the significantly increased risk of preeclampsia in IVF+PGT pregnancies, persisted upon stratification of analysis to only singleton live births. Conclusion(s): To date, this is the largest and most extensively controlled study examining maternal and neonatal outcomes after trophectoderm biopsy. There was a statistically significant three-fold increase in the odds of preeclampsia associated with trophectoderm biopsy. Given the rise in PGT use, further investigation is warranted.
AB - Objective: To assess whether pregnancies achieved with trophectoderm biopsy for preimplantation genetic testing (PGT) have different risks of adverse obstetric and neonatal outcomes compared with pregnancies achieved with IVF without biopsy. Design: Observational cohort. Setting: University-affiliated fertility center. Patient(s): Pregnancies achieved via IVF with PGT (n = 177) and IVF without PGT (n = 180) that resulted in a live birth. Intervention(s): None. Main Outcome Measure(s): Maternal outcomes including preeclampsia and placenta previa and neonatal outcomes including birth weight and birth defects. Result(s): There was a statistically significant increase in the risk of preeclampsia among IVF+PGT pregnancies compared with IVF without PGT pregnancies, with an incidence of 10.5% versus 4.1% (adjusted odds ratio [aOR] = 3.02; 95% confidence interval [95% CI], 1.10, 8.29). The incidence of placenta previa was 5.8% in IVF+PGT pregnancies versus 1.4% in IVF without PGT pregnancies (aOR = 4.56; 95% CI, 0.93, 22.44). Similar incidences of gestational diabetes, preterm premature rupture of membranes, and postpartum hemorrhage were observed. IVF+PGT and IVF without PGT neonates did not have a significantly different gestational age at delivery or rate of preterm birth, low birth weight, neonatal intensive care unit admission, neonatal morbidities, or birth defects. All trends, including the significantly increased risk of preeclampsia in IVF+PGT pregnancies, persisted upon stratification of analysis to only singleton live births. Conclusion(s): To date, this is the largest and most extensively controlled study examining maternal and neonatal outcomes after trophectoderm biopsy. There was a statistically significant three-fold increase in the odds of preeclampsia associated with trophectoderm biopsy. Given the rise in PGT use, further investigation is warranted.
KW - Preimplantation genetic testing
KW - in vitro fertilization
KW - maternal outcomes
KW - neonatal outcomes
KW - preeclampsia
KW - trophectoderm biopsy
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UR - http://www.scopus.com/inward/citedby.url?scp=85065568058&partnerID=8YFLogxK
U2 - 10.1016/j.fertnstert.2019.03.033
DO - 10.1016/j.fertnstert.2019.03.033
M3 - Article
C2 - 31103283
AN - SCOPUS:85065568058
SN - 0015-0282
VL - 112
SP - 283-290.e2
JO - Fertility and sterility
JF - Fertility and sterility
IS - 2
ER -