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Objective <p>The study provides a comparative analysis of the incidence of selected severe acute maternal morbidities after assisted reproductive technology (ART) and spontaneous conception in Slovak republic in the years 2012–2021.</p> Methods <p>Retrospective descriptive population-based analysis of selected severe acute maternal morbidities in pregnancies after ART compared to those after spontaneous conception in Slovakia from January 1, 2012 to December 31, 2021. The study included cases of Peripartum hysterectomy, Placenta accreta spectrum (PAS), Maternal intensive care unit (ICU) admission, HELLP syndrome, Sepsis, Eclampsia and Severe peripartum haemorrhage. Data were obtained from standardized anonymous questionnaires of the Slovak Gynaecology and Obstetrics Society (SGOS).</p> Results <p>A total of 559, 856 births were recorded in the years 2012–2021. Of these, 549,479 cases (98.15%) resulted from spontaneous conception, while 10,377 cases (1.85%) occurred following ART. The incidence of peripartum hysterectomy (per 1,000 births) in pregnancies after ART was 1.54 and after spontaneous conception was 0.78 (<i>p</i> = 0.006). PAS incidence was 0.48 after ART and 0.33 after spontaneous conception (<i>p</i> = 0.363). The incidence of maternal ICU admission after ART was 2.89 and after spontaneous conception 1.23 (<i>p</i> &lt; 0.001). The incidence of HELLP syndrome was 3.76 after ART and 0.50 after spontaneous conception (<i>p</i> &lt; 0.001). The incidence of sepsis was 0.77 after ART and 0.16 after spontaneous conception (<i>p</i> &lt; 0.001). The incidence of eclampsia after ART was 0.29% and 0.13% after spontaneous conception (<i>p</i> 0.247). The incidence of severe peripartum haemorrhage was 13.0 and 1.71 after spontaneous conception (<i>p</i> &lt; 0.001).</p> Conclusion <p>Maternal morbidity was significantly higher in pregnancies after ART compared to spontaneous conception throughout the study period in cases of peripartum hysterectomy, maternal ICU admission, HELLP syndrome, sepsis and severe peripartum haemorrhage. The risk of PAS and eclampsia was also higher after ART, but non-significantly. However, Slovakia maintains a lower maternal morbidity ratio in ART pregnancies compared to international data.</p>

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Severe Acute Maternal Morbidity after Assisted Reproductive Technology in Slovakia in the years 2012–2021

  • 期刊论文

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  • 发表日期：

    2026年3月7日

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  • Diana Štrbová,
  • Mária Vargová,
  • Adam Adamec,
  • Alexandra Krištúfková,
  • Dominika Kotríková,
  • Liam McCullough,
  • Rebeka Gabal,
  • Zuzana Nižňanská,
  • Jakub Daniš,
  • Miroslav Korbeľ

摘要

Objective

The study provides a comparative analysis of the incidence of selected severe acute maternal morbidities after assisted reproductive technology (ART) and spontaneous conception in Slovak republic in the years 2012–2021.

Methods

Retrospective descriptive population-based analysis of selected severe acute maternal morbidities in pregnancies after ART compared to those after spontaneous conception in Slovakia from January 1, 2012 to December 31, 2021. The study included cases of Peripartum hysterectomy, Placenta accreta spectrum (PAS), Maternal intensive care unit (ICU) admission, HELLP syndrome, Sepsis, Eclampsia and Severe peripartum haemorrhage. Data were obtained from standardized anonymous questionnaires of the Slovak Gynaecology and Obstetrics Society (SGOS).

Results

A total of 559, 856 births were recorded in the years 2012–2021. Of these, 549,479 cases (98.15%) resulted from spontaneous conception, while 10,377 cases (1.85%) occurred following ART. The incidence of peripartum hysterectomy (per 1,000 births) in pregnancies after ART was 1.54 and after spontaneous conception was 0.78 (p = 0.006). PAS incidence was 0.48 after ART and 0.33 after spontaneous conception (p = 0.363). The incidence of maternal ICU admission after ART was 2.89 and after spontaneous conception 1.23 (p < 0.001). The incidence of HELLP syndrome was 3.76 after ART and 0.50 after spontaneous conception (p < 0.001). The incidence of sepsis was 0.77 after ART and 0.16 after spontaneous conception (p < 0.001). The incidence of eclampsia after ART was 0.29% and 0.13% after spontaneous conception (p 0.247). The incidence of severe peripartum haemorrhage was 13.0 and 1.71 after spontaneous conception (p < 0.001).

Conclusion

Maternal morbidity was significantly higher in pregnancies after ART compared to spontaneous conception throughout the study period in cases of peripartum hysterectomy, maternal ICU admission, HELLP syndrome, sepsis and severe peripartum haemorrhage. The risk of PAS and eclampsia was also higher after ART, but non-significantly. However, Slovakia maintains a lower maternal morbidity ratio in ART pregnancies compared to international data.