BACKGROUND
It has been established that pregnancy after assisted reproductive technologies (ART) is significantly more often accompanied by the development of gestational diabetes mellitus (GDM), but the effect of GDM on the development of obstetric and perinatal complications of pregnancy after ART has not been studied enough to date.
OBJECTIVE
To determine the features of the course of pregnancy, delivery and perinatal outcomes in women with pregnancy after the use of ART and complicated by GDM.
MATERIALS AND METHODS
An observational single-center retrospective cohort continuous study was conducted, the main group (n=41) consisted of patients with pregnancy resulting from the use of ART complicated by GDM. The comparison group (n=35) included patients with pregnancy resulting from ART without GDM. The analysis of somatic and gynecological anamnesis, reproductive function was carried out, as well as perinatal complications and pregnancy outcomes in the observation groups were analyzed.
RESULTS
Patients with pregnancy after ART and complicated by GDM were significantly more likely than patients after ART without GDM to be overweight and obese (BMI=30.3 (26.0÷32.3) kg/m2 versus BMI=26.1 (24.3÷30.0) kg/m2; OR 4.96; 1.47—16.92; p=0.007), diseases of the cardiovascular system (OR 3.84; 1.23—11.96; p=0.003), hypothyroidism (OR 5.53; 1.42—21.29; p=0.008) and chronic diseases of the urinary system (OR 4.96; 1.47—16.92; p=0.007). The risk factors for the development of GDM in patients after ART include prolonged use of progesterone preparations after 22 weeks (OR 14.097; 4.71—42.21; p<0.001), use of IVF/ICSI programs (OR 2.751; 1.038—7.29; p=0.039). Pregnancy resulting from ART and proceeding against the background of GDM significantly more often than pregnancy after ART without GDM was complicated by the development of moderate (OR 1.083; 1.11—77.52; p=0.04) and severe preeclampsia (OR 1.038; 1.08—69.52; p=0.04), the formation of fetal macrosomia (OR 6.05; 1.24—29.541; p=0.023) and the development of postpartum hemorrhage (OR 9.27; 1.11—75, 21; p=0.016).
CONCLUSION
There is some synergy regarding the impact of GDM and the use of ART methods on the course of pregnancy, delivery and perinatal outcomes in patients with infertility. Timely detection of clinical and anamnestic risk factors, early diagnosis of GDM, and correction of carbohydrate metabolism disorders will help prevent and reduce the incidence of obstetric and perinatal complications in patients after the use of ART programs.
