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Advisor(s)
Abstract(s)
Introdução: Devido às crescentes taxas de infertilidade e à idade cada vez mais tardia da
primeira gravidez, a demanda por tecnologias de reprodução assistida (TRA), como é o caso
da fertilização in vitro (FIV), tem aumentado exponencialmente. Estudos realizados sobre o
impacto da reprodução assistida sobre a grávida e o recém-nascido têm revelado piores
resultados comparativamente à conceção natural. Dada a crescente utilização desta técnica,
torna-se necessário ter um bom conhecimento acerca dos riscos e complicações a que estão
sujeitas as grávidas quando optam por esta via de tratamento.
Objectivo: O nosso estudo pretende comparar a morbilidade dos recém-nascidos concebidos
por FIV com a daqueles concebidos por conceção natural, durante os períodos gestacional e
neonatal, cujo parto teve lugar no Centro Hospitalar Cova da Beira entre janeiro de 2011 e
dezembro de 2012.
Métodos: O nosso estudo é observacional retrospetivo, cuja amostra foi recolhida no Centro
Hospitalar Cova da Beira (CHCB), contabilizando todos os nascimentos entre janeiro de 2011 e
dezembro de 2012 (n = 1181). Para efeitos de análise, foram excluídas gravidezes gemelares,
gravidezes não vigiadas e as que foram medicamente assistidas com outra técnica que não
FIV, ficando a amostra com um tamanho final de n = 1086. As variáveis estudadas incidiram
sobre características maternas, do período gestacional materno, do parto e do período
neonatal.
Resultados: Entre o início de 2011 e o final de 2012, foram registados, no CHCB, 15 casos
(1,4%) de recém-nascidos únicos nascidos por FIV, cuja gravidez foi devidamente vigiada. As
mulheres que conceberam por FIV apresentam, com maior frequência, idade mais avançada e
são maioritariamente primigestas quando as comparamos às mulheres que conceberam
naturalmente. O período gestacional é comparável entre ambos os grupos, encontrando-se
apenas uma associação estatisticamente significativa entre FIV e a ocorrência de hemorragia
pré-parto. Verificamos que as gravidezes por FIV apresentam uma maior taxa de partos
distócicos, nomeadamente cesariana. Comparativamente aos recém-nascidos concebidos
naturalmente, as crianças concebidas por FIV têm maior tendência a apresentar baixo peso à
nascença (<2,500 kg), índice de APGAR (IA) ao 5º minuto <7 e maior taxa de mortalidade.
Conclusão: Os recém-nascidos concebidos por FIV estão associados a uma maior taxa de
complicações durante o período gestacional, parto e período neonatal. Dado o aumento
exponencial da recorrência a esta técnica pelos casais inférteis, torna-se necessário conhecer
e explicar os riscos a que os pacientes estarão sujeitos a fim de que estes possam tomar uma
decisão mais consciente e informada acerca do assunto. Por outro lado, quanto melhor conhecermos os riscos que estas gravidezes acarretam, melhor os poderemos prevenir ou
tratar.
Introduction: The rising infertility rate and a first pregnancy at an older age, have led to an exponential increase for assisted conception technologies, such as in vitro fertilization (IVF). Studies concerning the impact of assisted conception on the pregnant women and the newly born have shown worse results than those achieved by natural conception. The rising use of this technology demands a good knowledge of the risks and complications that women are exposed when they choose this kind of treatment. Objective: The aim of our study is to compare the morbidity of newly born conceived through assisted conception with those conceived naturally, during the gestational and neonatal periods, of babies born in the Centro Hospitalar Cova da Beira between January 2011 and December 2012. Design: Our study is retrospective observational and our samples were collected at the Centro Hospitalar Cova da Beira (CHCB), accounting all births between January 2011 and December 2012 (n = 1181). For analysis purposes, twin pregnancies, non-assisted pregnancies and pregnancies medically assisted with a technique different from in vitro fertilization (IVF) were omitted from the study leaving a final sample of n = 1086. The studied parameters focused on maternal features, the maternal gestational period, labor and neonatal period. Results: Between the beginning of 2011 and the end of 2012, 15 cases (1,4%) of newly borns conceived by IVF and whose pregnancy period was monitored, were listed at the CHCB. Women who conceived by IVF, present, in comparison with women who conceived natuarally, a higher frequency of advanced age and primigravidae. The gestational period is comparable amongst both groups. Only one statistically relevant association between IVF and the manifestation of antepartum bleeding was encountered. We verified that IVF pregnancies present a higher rate of dystocic deliveries, namely cesarean. In comparison with newly born naturally conceived, babies conceived by IVF present, a higher tendency towards lower weight at birth (<2,500 Kg), APGAR score at the 5th minute <7 and a higher mortality rate. Conclusions: Newly born conceived by IVF are associated with a higher frequency of complications during the gestational period, labor and neonatal period. The use of this technique by unfertile couples is increasing exponentially, therefore knowledge of the risks that patients are subjected must be known, so that these can be informed and make a more thorough and informed decision on the matter. On the other hand, an increased knowledge of the risks of these pregnancies, will improve the chance of prevention and treatment.
Introduction: The rising infertility rate and a first pregnancy at an older age, have led to an exponential increase for assisted conception technologies, such as in vitro fertilization (IVF). Studies concerning the impact of assisted conception on the pregnant women and the newly born have shown worse results than those achieved by natural conception. The rising use of this technology demands a good knowledge of the risks and complications that women are exposed when they choose this kind of treatment. Objective: The aim of our study is to compare the morbidity of newly born conceived through assisted conception with those conceived naturally, during the gestational and neonatal periods, of babies born in the Centro Hospitalar Cova da Beira between January 2011 and December 2012. Design: Our study is retrospective observational and our samples were collected at the Centro Hospitalar Cova da Beira (CHCB), accounting all births between January 2011 and December 2012 (n = 1181). For analysis purposes, twin pregnancies, non-assisted pregnancies and pregnancies medically assisted with a technique different from in vitro fertilization (IVF) were omitted from the study leaving a final sample of n = 1086. The studied parameters focused on maternal features, the maternal gestational period, labor and neonatal period. Results: Between the beginning of 2011 and the end of 2012, 15 cases (1,4%) of newly borns conceived by IVF and whose pregnancy period was monitored, were listed at the CHCB. Women who conceived by IVF, present, in comparison with women who conceived natuarally, a higher frequency of advanced age and primigravidae. The gestational period is comparable amongst both groups. Only one statistically relevant association between IVF and the manifestation of antepartum bleeding was encountered. We verified that IVF pregnancies present a higher rate of dystocic deliveries, namely cesarean. In comparison with newly born naturally conceived, babies conceived by IVF present, a higher tendency towards lower weight at birth (<2,500 Kg), APGAR score at the 5th minute <7 and a higher mortality rate. Conclusions: Newly born conceived by IVF are associated with a higher frequency of complications during the gestational period, labor and neonatal period. The use of this technique by unfertile couples is increasing exponentially, therefore knowledge of the risks that patients are subjected must be known, so that these can be informed and make a more thorough and informed decision on the matter. On the other hand, an increased knowledge of the risks of these pregnancies, will improve the chance of prevention and treatment.
Description
Keywords
Chcb Fertilização In Vitro Infertilidade Neonatologia Tecnologias de Reprodução Assistida