The goal of this prospective cohort study is to examine how different parameters of assisted reproductive technologies (ART) are associated with the perinatal outcome in individuals with singleton or multiple gestations. The main questions it aims to answer are:
Are ART pregnancies associated with a higher risk of:
* Small for gestational age neonates? * Fetal growth restriction, either early- or late-onset? * Development of preeclampsia? * Stillbirth (intrauterine fetal death after 22 weeks not due to known anomalies)? * Are certain ART parameters-such as the type of fertilization (e.g., IVF vs. ICSI), embryo stage at transfer, use of fresh vs. frozen embryos, or ovarian stimulation protocols-more strongly associated with adverse outcomes?
Are ART pregnancies associated with placental and umbilical cord abnormalities, including:
* Placenta previa? * Vasa previa? * Single umbilical artery? * Velamentous or marginal cord insertion?
Researchers will compare outcomes between pregnancies conceived through ART and those conceived spontaneously.
Participants will:
* Be individuals aged 18 or older undergoing routine first-trimester ultrasound between 11 and 14 weeks of gestation * Provide detailed medical, obstetric, and ART-related information * Undergo routine prenatal assessments, including ultrasound evaluations of fetal growth, Doppler studies, and placental characteristics * Have perinatal outcomes such as gestational age at birth, mode of delivery, birthweight, and complications systematically recorded
Statistical models will be used to adjust for confounding factors such as maternal age, BMI, parity, and smoking.
The aim is to better understand how ART and specific ART parameters may influence maternal and neonatal health and to improve counseling and clinical care for people using fertility treatments.
Singleton or multiple pregnancies
Live fetus between 11 weeks plus 0 days and 13 weeks plus 6 days of gestation
Known genetic anomalies diagnosed before or after birth
Major fetal defects diagnosed before or after birth, such as acrania, holoprosencephaly, megacystis, exomphalos, congenital heart defects
All consecutive women 18 years old or older who attend for routine ultrasound examination at 11 weeks plus 0 days to 13 weeks plus 6 days of gestation at one of participating fetal medicine units.
Cohort
Prospective
Not listed
Small for gestational age neonates
Small for gestational age neonates defined as birthweight lower than the 10th percentile
Development of preeclampsia
New onset of hypertension (systolic pressure ≥140 and/or diastolic pressure ≥90 mmHg) and proteinuria or the new onset of hypertension plus significant end-organ dysfunction with or without proteinuria, typically presenting after 20 weeks of gestation or postpartum.
Fetal growth restriction
Fetal growth restriction, either early-onset (\<32 weeks) or late-onset (\>32 weeks), characterized by an estimated fetal weight below the 3rd percentile or below the 10th percentile based on the Fetal Medicine Foundation fetal growth charts accompanied by abnormal Doppler findings; or birthweight below the 5th centile based on the FMF neonatal growth charts
Stillbirth
Stillbirth (intrauterine demise after 22 weeks gestation not attributable to other causes (i.e. congenital infections, structural defects, genetic anomalies)
Placenta previa
Placenta partially or completely covers the internal cervical os.
Vasa previa
Vasa previa occurs when fetal blood vessels that are unprotected by the umbilical cord or placenta run through the amniotic membranes and traverse the cervix.
Single umbilical artery
Umbilical cord with one instead of two umbilical arteries
Velamentous and marginal cord insertions
Abnormal cord insertions
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Aristotle University Of Thessaloniki
Lead sponsor
Hospital Universitario de Torrejón,Madrid
Collaborator
Universidad Francisco de Vitoria
Collaborator
University Hospital, Pleven, Bulgaria
Collaborator
Hospital Universitario Virgen de la Arrixaca
Collaborator
Hospital Universitario de Canarias
Collaborator
