Maternal And Neonatal Outcomes In Singleton Pregnancies Following In Vitro Fertilisation: A Retrospective Cohort Study With Adjusted Risk Estimates

Abstract

Background

Singleton pregnancies conceived through in vitro fertilisation (IVF) have been associated with adverse maternal and neonatal outcomes; however, the extent to which these risks persist after adjustment for maternal characteristics remains uncertain, particularly in low- and middle-income settings.

Objective:
To compare maternal and neonatal outcomes between IVF-conceived and spontaneously conceived singleton pregnancies in a tertiary care setting.

Methods:
This retrospective cohort study included 70 IVF-conceived and 140 spontaneously conceived singleton pregnancies delivered between January and December 2025. Frequency matching was performed for maternal age and parity. Multivariable logistic regression was used to estimate adjusted odds ratios (aORs) with 95% confidence intervals, controlling for maternal age, body mass index, and parity.

Results:
IVF conception was associated with higher odds of cesarean delivery (aOR 11.06, 95% CI 5.26–23.22), hypertensive disorders of pregnancy (aOR 3.42, 95% CI 1.33–8.80), and gestational diabetes mellitus (aOR 4.86, 95% CI 2.28–10.37). Neonatal outcomes, including preterm birth (aOR 5.62, 95% CI 2.60–12.13) and low birth weight (aOR 2.40, 95% CI 1.16–4.99), were also more frequent in IVF pregnancies. Estimates for less common outcomes were imprecise. Subgroup analyses within the IVF cohort did not show consistent associations between treatment-related factors and adverse outcomes.

Conclusions:
In this cohort, IVF conception was associated with higher observed rates of several maternal and neonatal outcomes after adjustment for selected maternal characteristics. These findings should be interpreted cautiously, given the potential for residual confounding and centre-specific clinical practices. Larger prospective studies are needed to clarify the independent contribution of IVF-related factors.