Comorbidities, risk factors and maternal/perinatal outcomes in oocyte donation pregnancies: A single-centre study on a contemporary cohort of singleton pregnancies

Abstract Research Question To evaluate pre-existing comorbidities, obstetric risks factors and adverse obstetric and neonatal outcomes in pregnancies conceived by oocyte donation (OD), as compared to spontaneously conceived (SC) pregnancies or by conventional in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). Design In a retrospective single-centre cohort study, data from singleton deliveries occurring at the University Hospital of Careggi, Florence, from 2009 to 2017 were reviewed. Maternal and perinatal outcomes were analysed. Results The study included 25851 pregnancies and new-borns: 276 (1.1%) children were conceived after OD, 925 (3,6%) after IVF-ICSI and 24650 (95.4%) after SC. The OD groups included patients who were significantly older and with a higher prevalence of chronic hypertension. They were administered anticoagulant medications more frequently in their pregnancies. The incidence of gestational hypertension was significantly higher than in SC (aOR 3.6) and IVF/ICSI pregnancies (aOR 2.7). The incidence of caesarean section (CS) in OD pregnancies was higher than in both SC and IVF/ICSI groups (aOR 3.4 and aOR 2.3 respectively). An elevenfold increased risk of postpartum haemorrhage (PPH) was found in OD versus SC and a threefold increased risk was found in OD versus IVF/ICSI; prematurity and low birth weight (LBW) were more frequent after OD versus SC (aOR 2.4 for preterm birth and aOR 1.8 for LBW). Conclusions Patients undergoing OD represent a group with increased comorbidities and risk factors for adverse obstetric outcomes. OD seems to be independently associated with gestational hypertension and PPH. Pregnancies after OD warrant clinical surveillance with proper screening and, possibly, preventive strategies.