PREGNANCIES ACHIEVED BY ART ARE PRONE TO BE HIGH-RISK PREGNANCIES: IS REFERRAL TO A TERTIARY CENTER REQUIRED?

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Ocakoğlu S. R., Atak Z., Yalçın S., Özgün Uyanıklar Ö.

13th Scientific Meeting of the Turkish Society of Reproductive Medicine, Antalya, Türkiye, 20 - 23 Kasım 2025, cilt.51, ss.30, (Tam Metin Bildiri)

  • Yayın Türü: Bildiri / Tam Metin Bildiri
  • Cilt numarası: 51
  • Doi Numarası: 10.1016/j.rbmo.2025.105320
  • Basıldığı Şehir: Antalya
  • Basıldığı Ülke: Türkiye
  • Sayfa Sayıları: ss.30
  • Bursa Uludağ Üniversitesi Adresli: Evet

Özet

OBJECTIVE: Fertility specialists com- monly refer patients to obstetricians after detecting a biochemical or clini- cal pregnancy. However, a significant number of patients do not reach the stage of live birth, which is one of the most critical indicators of IVF success. This underscores the importance of pregnancy monitoring and manage- ment in the success of fertility treat- ments. This study aims to evaluate whether pregnancies conceived through ART should be classified as high-risk and, if so, whether system- atic referral from fertility units to ter- tiary perinatology centers improves maternalfetal care.

MATERIALS AND METHODS: This retrospective cohort study included 109 IVF pregnancies managed at Bursa City Hospital between August 2019 and January 2025. Data on maternal characteristics, comorbid- ities, and first-trimester screening were collected from electronic records. The primary outcome was referral to perinatology; secondary outcomes included live birth, preterm delivery, and neonatal status. Patients

were grouped based on perinatology referral status.

RESULTS: The median maternal age was 31 years and median gravida was 1. Comorbidities were present in 46.8% and multiple gestations in 35.8% of cases. Cerclage was applied in 7.3%, and 42.2% had normal aneu- ploidy screening results, while 57.8% were not screened. Live birth occurred in 74.3%, preterm delivery in 33%, and 54.1% of patients required perinatology referral. Although maternal age did not differ between referral and non-referral groups (p = 0.292), gravida number was higher in the referral group (2 vs. 1; p = 0.047). Comorbidities (64.4% vs. 26%; p < 0.001) and threatened preterm labor (60.4% vs. 9.3%; p <0.001) were significantly more fre- quent in the referral group. Comor- bidities increased referral risk 3.43 times (95% CI: 1.239.54; p=0.018), and threatened preterm labor increased it 13.32 times (95% CI: 3.3453.12; p < 0.001). Other factors did not significantly affect referral status.

CONCLUSIONS: More than half of ART pregnancies in this tertiary set- ting required specialist perinatology input, due to maternal comorbid- ities and early signs of preterm labor. Integrating fertility clinics with tertiary centers and establishing clear referral pathways may improve outcomes by enabling early identifi- cation and management of high-risk cases.

IMPACT STATEMENT: This study supports classifying ART pregnancies as high-risk and emphasizes the need for structured referral to tertiary peri- natology centers to improve maternal and neonatal outcomes.

Keywords: Assisted reproductive technology pregnancies; high-risk pregnancies; perinatology assessment