Differences in Pregnancy Outcomes Between in vitro Fertilization and Natural Conception in Nulliparous Singleton Pregnancies of Advanced Maternal Age: A Study Based on Propensity Score Matching and Cohort Retrospective Analysis

体外受精与自然受孕在初产妇高龄单胎妊娠中妊娠结局的差异:一项基于倾向评分匹配和队列回顾性分析的研究

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Abstract

OBJECTIVE: To compare pregnancy outcomes between in vitro fertilization (IVF) and natural conception in singleton pregnancies among nulliparous of advanced maternal age. PATIENTS AND METHODS: This retrospective analysis utilized propensity score matching (PSM) on 128 cases in the IVF group and 196 cases in the natural conception group, selected from the Second Nanning People's Hospital between January 2020 and December 2023. Early and late pregnancy outcomes assessed included hemoglobin (Hb) levels, oligohydramnios, fetal growth restriction (FGR), gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy (HDP), placenta previa, placental abruption, premature rupture of membranes, fetal distress, mode of delivery, gestational age at delivery, preterm birth, low birth weight, macrosomia, and blood loss during delivery. RESULTS: The IVF group exhibited a higher incidence of oligohydramnios and a lower incidence of low birth weight compared to the natural conception group, with both differences being statistically significant (P < 0.05). No significant differences were found between the two groups for other pregnancy complications. CONCLUSION: Pregnancy outcomes for IVF and natural conception are comparable in singleton pregnancies among nulliparous of advanced maternal age. However, clinicians should remain vigilant regarding the risks of oligohydramnios and low birth weight in IVF pregnancies to ensure appropriate monitoring and intervention.

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