Association between antiphospholipid syndrome and outcomes of singleton pregnancies conceived via assisted reproductive technology (ART): A Nationwide Inpatient Sample analysis 2005-2020.

INTRODUCTION

Antiphospholipid syndrome (APS) is an autoimmune disorder that increases the risk of blood clots and pregnancy complications. While the effects of APS on natural pregnancies are known, its impact on pregnancies conceived using assisted reproductive technologies (ART), such as in vitro fertilization (IVF), is unclear. This study aims to investigate the outcomes of ART pregnancies in individuals with APS.

METHODS

Data from the Nationwide Inpatient Sample (NIS) from 2005 to 2020 were analyzed. Individuals with singleton pregnancies conceived via ART were categorized into those with and without APS. The primary outcomes assessed were maternal and fetal complications and were compared between individuals with and without APS.

RESULTS

After propensity-score matching, data from 3730 individuals (746 with APS) were analyzed. Individuals with APS had a significantly higher risk of preeclampsia (odds ratio [OR] = 1.87), cesarean delivery (OR = 1.29), uterine atony (OR = 1.54), disseminated intravascular coagulation (DIC) (OR = 3.96), HELLP syndrome (OR = 2.48), and fetal growth restriction (FGR) (OR = 1.41) compared to those without APS. In individuals over 35 years old, APS was associated with increased risks of preeclampsia (OR = 1.65), DIC (OR = 4.07), and HELLP syndrome (OR = 1.75). Among individuals ≤35 years old, APS increased the risks of preeclampsia (OR = 2.35), cesarean delivery (OR = 1.53), HELLP syndrome (OR = 4.31), and stillbirth/intrauterine fetal death (OR = 2.44).

CONCLUSIONS

APS in ART pregnancies is associated with increased maternal and fetal complications.