Risk for Severe Maternal Morbidity Elevated for Pregnancy Surrogates
MONDAY, Sept. 23, 2024 -- The risk for severe maternal morbidity (SMM) and adverse pregnancy outcomes is increased for gestational carriers, or pregnancy surrogates, compared with women conceiving naturally or via in vitro fertilization (IVF), according to a study published online Sept. 24 in the Annals of Internal Medicine.
Maria P. Velez, M.D., Ph.D., from Queen's University Kingston in Ontario, Canada, and colleagues conducted a population-based cohort study to examine the risk for SMM and severe neonatal morbidity (SNM) in gestational carriers.
Of the eligible singleton births, 846,124, 16,087, and 806 (97.6, 1.8, and 0.1 percent, respectively), were via unassisted conception, IVF, and gestational carriage, respectively. The researchers found that the risks for SMM were 2.3, 4.3, and 7.8 percent for unassisted conception, IVF, and gestational carriage, respectively. The weighted relative risks were 3.30 and 1.86, respectively, comparing gestational carriage with unassisted conception and IVF. For SNM, the respective risks were 5.9, 8.9, and 6.6 percent; the weighted relative risks were not significantly increased for gestational carriage versus unassisted conception or IVF. Comparing gestational carriers with either comparison group, hypertensive disorder, postpartum hemorrhage, and preterm birth at less than 37 weeks were also significantly higher.
"Given the increasing use of gestational carriers, and the potentially higher risk for SMM and other adverse pregnancy outcomes, a judicious selection of these carriers may be warranted -- something recommended within clinical practice guidelines," the authors write.
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