Placental abruption in ART pregnancies poses risk of preterm delivery

The occurrence of placental abruption in pregnant women who conceived via assisted reproductive technology (ART) contributes to an increased risk of preterm delivery, as reported in a cross-sectional study.

Researchers used data from the National Inpatient Sample in the US and identified women between 15 and 54 years of age who gave birth between 2000 and 2019. Risks of placental abruption and preterm delivery (<37 weeks of gestation) were compared between pregnancies conceived via ART and those conceived spontaneously.

A total of 78,901,058 deliveries were included in the analysis. The mean age of the mothers was 27.9 years, and 44.2 percent were White. In the subset of hospital births, 98.2 percent were singleton pregnancies, 68.8 percent were vaginal deliveries, and 52.1 percent were covered by private insurance.

The incidence rate of placental abruption was 11 per 1,000 hospital discharges among spontaneous conceptions and 17 per 1,000 hospital discharges among ART conceptions.

In multivariable weighted logistic regression models, ART conception was associated with greater odds of placental abruption compared with spontaneous conception (adjusted odds ratio [aOR], 1.42, 95 percent confidence interval [CI], 1.34–1.51), with the association being more pronounced in White (aOR, 1.42, 95 percent CI, 1.31–1.53) vs Black women (aOR, 1.16, 95 percent CI, 0.93–1.44).

Moreover, the odds of preterm delivery were significantly higher in pregnancies conceived by ART than spontaneously (aOR, 1.46, 95 percent CI, 1.42–1.51).

The risk of preterm delivery was twofold higher among women who conceived via ART and had placental abruption (relative excess risk due to interaction, 2.0, 95 percent CI, 0.5–3.5).