Maternal and Fetal Outcome after Assisted Conception in Port Harcourt, Nigeria

Background: The introduction of assisted reproductive technology (ART) has played a major role in reducing the burden of infertility among couples. Although most pregnancies following assisted conception will progress normally without any increased risk to the mother or baby, studies have shown that some women who conceive in this manner as well as their babies are indeed at increased risk of complications.

Objective: To evaluate the maternal and neonatal outcome after assisted reproductive technique (ART) in Port Harcourt, Nigeria.

Materials and Methods: A retrospective case control study of 51 women who conceived via ART (subjects) and 51 women who conceived spontaneously (control) managed at the obstetric unit of the University of Port Harcourt Teaching Hospital, (UPTH), Nigeria over an 8-year period was conducted. Data obtained from theatre records and case notes of patients were analysed using the statistical package SPSS 20.

Results: The rate of multiple pregnancy was 47% (24 women) in the ART group compared with 6% (3 women) in the control group and this was statistically significant (p = 0.001). Thirty-one (61%) of the women had adverse outcomes in the ART group compared to 9 (18%) in the control group and this was statistically significant (p = 0.001). Early pregnancy bleeding (p =0.03), hypertensive disorders of pregnancy (p = 0.05), pre term delivery (p = 0.002) caesarean delivery (p = 0.001), low birth weight (p = 0.001) neonatal admission (p = 0.02) and perinatal deaths (p = 0.03) were significantly commoner in the assisted conception group. The rates of antepartum haemorrhage, diabetes mellitus, postpartum haemorrhage, maternal death and mild birth asphyxia were not statistically different between the two groups.

Conclusion: ART pregnancies are associated with more adverse feto-maternal outcomes compared with spontaneously conceived pregnancies.