Major postpartum haemorrhage after frozen embryo transfer: A population‐based study

Author:

Al‐Khatib Amélie1,Sagot Paul1,Cottenet Jonathan2,Aroun Massinissa1,Quantin Catherine2345ORCID,Desplanches Thomas16ORCID

Affiliation:

1. Pôle de Gynécologie‐Obstétrique et Biologie de la Reproduction Dijon University Hospital Dijon France

2. Service de Biostatistique et d'Informatique Médicale (DIM) Dijon University Hospital Dijon France

3. Clinical Epidemiology Unit Inserm, CIC 1432 Dijon France

4. Clinical Investigation Centre Dijon University Hospital Dijon France

5. Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases (B2PHI), INSERM, UVSQ Institut Pasteur, Université Paris‐Saclay Paris France

6. Geneva School of Health Sciences HES‐SO University of Applied Sciences and Arts Western Switzerland Geneva Switzerland

Abstract

AbstractObjectiveTo investigate the effect on major postpartum haemorrhage (PPH) of mode of conception, differentiating between naturally conceived pregnancies, fresh embryo in vitro fertilisation (fresh‐IVF) and frozen embryo transfer (frozen‐IVF).DesignRetrospective cohort study.SettingThe French Burgundy Perinatal Network database, including all deliveries from 2006 to 2020, was linked to the regional blood centre database.Population or sampleIn all, 244 336 women were included, of whom 240 259 (98.3%) were singleton pregnancies.MethodsThe main analyses were conducted in singleton pregnancies, including 237 608 naturally conceived, 1773 fresh‐IVF and 878 frozen‐IVF pregnancies. Multivariate logistic regression models adjusted on maternal age, body mass index, smoking, parity, induction of labour, hypertensive disorders, diabetes, placenta praevia and/or accreta, history of caesarean section, mode of delivery, birthweight, birth place and year of delivery, were used.Main outcome measuresMajor PPH was defined as PPH requiring blood transfusion and/or emergency surgery and/or interventional radiology.ResultsThe prevalence of major PPH was 0.74% (n = 1749) in naturally conceived pregnancies, 1.92% (n = 34) in fresh‐IVF pregnancies, and 3.30% (n = 29) in frozen‐IVF pregnancies. The risk of major PPH was higher in frozen‐IVF pregnancies than in both naturally conceived pregnancies (adjusted odds ratio [aOR] 2.63, 95% CI 1.68–4.10) and fresh‐IVF pregnancies (aOR 2.78, 95% CI 1.44–5.35).ConclusionsWe found that frozen‐IVF pregnancies have a higher risk of major PPH and they should be subject to increased vigilance in the delivery room.

Publisher

Wiley

Subject

Obstetrics and Gynecology

Reference34 articles.

1. ART in Europe, 2018: results generated from European registries by ESHRE

2. Centers for Disease Control and Prevention.Assisted reproductive technology. Fertility Clinic and National Summary Report.2019.

3. Agence de la Biomédecine.Assistance médicale à la procréation‐PRINCIPAUX CHIFFRES DE L'ACTIVITÉ. 2020 [cited 2023 May 01]. Available from:https://www.agence‐biomedecine.fr/Le‐rapport‐annuel‐et‐le‐rapport‐medical‐et‐scientifique‐2021‐sont‐en‐ligne

4. Oocyte, embryo and blastocyst cryopreservation in ART: systematic review and meta‐analysis comparing slow‐freezing versus vitrification to produce evidence for the development of global guidance;Rienzi L;Hum Reprod Update,2017

5. Pregnancy-related complications and perinatal outcomes resulting from transfer of cryopreserved versus fresh embryos in vitro fertilization: a meta-analysis

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