Increased risk of placenta previa in pregnancies following IVF/ICSI; a comparison of ART and non-ART pregnancies in the same mother.
BACKGROUND
The risk of placenta previa may be increased in pregnancies conceived by assisted reproduction technology (ART). Whether the increased risk is due to factors related to the reproductive technology, or associated with maternal factors, is not known.


METHODS
In a nationwide population-based study, we included 845,384 pregnancies reported to the Medical Birth Registry of Norway between 1988 and 2002 and compared the risk of placenta previa in 7568 pregnancies conceived after assisted fertilization, with the risk in naturally conceived pregnancies. To study the influence of ART more directly, we compared the risk of placenta previa between consecutive pregnancies among 1349 women who had conceived both naturally and after assisted fertilization. Odds ratios (OR), adjusted for maternal age, parity, previous Caesarean section and time interval between pregnancies were estimated using logistic regression.


RESULTS
There was a six-fold higher risk of placenta previa in singleton pregnancies conceived by assisted fertilization compared with naturally conceived pregnancies [adjusted OR 5.6, 95% confidence interval (CI) 4.4-7.0]. Among mothers who had conceived both naturally and after assisted fertilization, the risk of placenta previa was nearly three-fold higher in the pregnancy following assisted fertilization (adjusted OR 2.9, 95% CI 1.4-6.1), compared with that in the naturally conceived pregnancy.


CONCLUSIONS
The use of ART is associated with an increased risk of placenta previa. Our findings suggest that the increased risk may be caused by factors related to the reproductive technology.
Romundstad
Liv Bente
LB
Department of Obstetrics and Gynaecology, St Olavs University Hospital, Torndheim, Norway. libero@ntnu.no
Romundstad
Pål R
PR
Sunde
Arne
A
von Düring
Vidar
V
Skjaerven
Rolv
R
Vatten
Lars J
LJ
D000328:Adult; D005260:Female; D005306:Fertilization; D005307:Fertilization in Vitro / Q000009:adverse effects*; D006801:Humans; D008423:Maternal Age; D009035:Mothers; D016017:Odds Ratio; D010298:Parity; D010923:Placenta Previa / Q000175:diagnosis* / Q000473:pathology; D011247:Pregnancy; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk; D027724:Reproductive Techniques, Assisted / Q000009:adverse effects*; D012306:Risk; D012307:Risk Factors; D020554:Sperm Injections, Intracytoplasmic / Q000009:adverse effects*