# Impact of fertility treatments on perinatal outcomes in pregnancies complicated by GDMA1: a comparative cohort study

## TL;DR

This study compares pregnancy outcomes in women with GDMA1 who used fertility treatments versus natural conception, finding both risks and benefits.

## Contribution

The study identifies fertility treatments as a novel independent predictor of specific perinatal outcomes in GDMA1 pregnancies.

## Key findings

- Fertility treatments were linked to higher rates of preeclampsia, hypertension, preterm birth, and cesarean delivery in GDMA1 pregnancies.
- Fertility treatments were associated with lower rates of macrosomia and polyhydramnios in GDMA1 pregnancies.
- Fertility treatments were identified as an independent predictor of cesarean delivery but a protective factor against macrosomia.

## Abstract

To investigate adverse pregnancy and delivery outcomes in women with GDMA1 during pregnancies conceived through fertility treatments.

This population-based retrospective cohort study examined adverse pregnancy and delivery outcomes in pregnancies affected by GDMA1 following fertility treatments compared to those conceived naturally. Women with GDMA1 who conceived via fertility treatments were classified as cases, while those who conceived naturally were designated as controls. Multivariable logistic regression models were employed to evaluate the association between fertility treatments and perinatal outcomes in pregnancies complicated by GDMA1.

The study cohort consisted of 12,841 pregnant women diagnosed with GDMA1, of whom 640 (4.98%) conceived through fertility treatments, while the remaining 12,201 conceived naturally. Women with GDMA1 who conceived through fertility treatments had significantly higher rates of preeclampsia, hypertension, preterm birth, and cesarean delivery, while they experienced lower rates of macrosomia and polyhydramnios compared with women who conceived spontaneously. Multivariate analysis identified fertility treatments as an independent predictor of cesarean delivery, while conversely serving as a protective factor against macrosomia after adjusting for maternal age, parity, hypertensive disorders of pregnancy, and labor induction.

Women with GDMA1 who conceived through fertility treatments experienced a reduced incidence of complications associated with GDM, such as macrosomia and polyhydramnios. This could be explained by better GDM control and adherence to a more rigorous prenatal care approach. However, they faced an increased risk of other obstetric complications, including pre-eclampsia, preterm delivery, and cesarean delivery.