Maternal and perinatal outcomes in pregnancies conceived after infertility treatment at a tertiary care centre in Chhattisgarh: a prospective observational study

Sonalika A. Bhad; Sangeeta Kamra; Prabhdeep Kaur

doi:10.18203/2320-1770.ijrcog20260549

Authors

Sonalika A. Bhad Department of Obstetrics and Gynecology, JLNHRC, Bhilai, Chhattisgarh, India
Sangeeta Kamra Department of Obstetrics and Gynecology, JLNHRC, Bhilai, Chhattisgarh, India
Prabhdeep Kaur Department of Obstetrics and Gynecology, JLNHRC, Bhilai, Chhattisgarh, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20260549

Keywords:

Assisted reproductive techniques, Fertilization in vitro, India, Low birth weight, Pregnancy complications, Premature birth, Infant

Abstract

Background: Infertility affects 10-15% of couples in India, with increasing reliance on ovulation induction, intrauterine insemination (IUI), and assisted reproductive technologies (ART). Pregnancies conceived following infertility treatment have been associated with higher maternal and perinatal risks. Objective of this study was to evaluate maternal and fetal complications in pregnancies conceived after infertility treatment and identify factors influencing maternal-neonatal morbidity.

Methods: A prospective observational study was conducted over 12 months at a tertiary care center in Chhattisgarh. Sixty antenatal women who conceived after infertility treatment (OI, IUI, IVF, fertility-enhancing surgery) were enrolled. Demographic, clinical, obstetric, and neonatal outcomes were analysed using descriptive statistics.

Results: Mean maternal age was 31.8 years; 68.3% had primary infertility. PCOS was the most common female cause (56.7%). IVF accounted for 40% of conceptions, while OI+TI accounted for 43.3%. Medical complications included gestational hypertension (26.7%), GDM (26.7%), IHCP (16.7%), and preeclampsia (3.3%). PROM occurred in 15%, and preterm labor in 5%. LSCS rate was high (78.3%), with 87.5% of IVF pregnancies delivered by LSCS. Neonatal outcomes showed 31.8% low birth weight and 7.6% very low birth weight infants. Preterm delivery occurred in 23.3%.

Conclusions: Pregnancies conceived after infertility treatment especially those resulting from IVF, older maternal age, PCOS, obesity, and long-standing infertility were associated with higher risks of hypertensive disorders, GDM, PROM, preterm birth, LSCS, and low birth weight. Enhanced antenatal surveillance and multidisciplinary management are essential to optimize outcomes.

References

World Health Organization. Infertility. Geneva: WHO; 2023. Available at: https://www.who.int/ news-room/fact-sheets/detail/infertility. Accessed on 10 November 2025.

International Institute for Population Sciences (IIPS), ICF. National Family Health Survey (NFHS-5), 2019–21: India. Mumbai: IIPS; 2021. Available at: https://www.nfhsiips.in/nfhsuser/nfhs5.php. Accessed on 10 November 2025.

Indian Council of Medical Research (ICMR). National infertility prevalence survey report. New Delhi: ICMR. Available at: https://www.icmr.gov.in/. Accessed on 10 November 2025.

Practice Committee of the American Society for Reproductive Medicine. Definitions of infertility and recurrent pregnancy loss: a committee opinion. Fertil Steril. 2020;113(3):533-5. DOI: https://doi.org/10.1016/j.fertnstert.2019.11.025

Teede HJ, Misso ML, Costello MF, Dokras A, Laven J, Moran L, et al. Recommendations from the international evidence-based guideline for PCOS management. Hum Reprod. 2018;33(9):1602-18. DOI: https://doi.org/10.1093/humrep/dey256

Chih HJ, Elias FTS, Gaudet L, Velez MP. Assisted reproductive technology and hypertensive disorders of pregnancy: systematic review and meta-analysis. Hum Reprod Update. 2021;27(6):1015-33. DOI: https://doi.org/10.21203/rs.3.rs-406764/v1

Lei LL, Lan YL, Wang SY, Feng W, Zhai ZJ. Perinatal outcomes in pregnancies conceived by ART: a systematic review and meta-analysis. Sci Rep. 2019;9:14435.

Thyagarajan C, Gupta N, Suneetha N. Maternal and perinatal outcome in pregnancies conceived following infertility treatment. J Obstet Gynaecol India. 2010;60(5):404-8.

Centers for Disease Control and Prevention. 2015 Assisted Reproductive Technology National Summary Report. Atlanta (GA): CDC; 2017. Available at: https://ftp.cdc.gov/pub/publications/ art/ART-2015-Clinic-Report-Full.pdf. Accessed on 10 November 2025.

Zhang X, et al. Perinatal and infant outcomes after assisted reproductive technology treatment: population register-based cohort study. Fertil Steril. 2025;124(3):456-67.

Shan D, Qiu PY, Wu YX, Chen Q, Li AL, Ramadoss S, et al. Pregnancy outcomes in women of advanced maternal age: a retrospective cohort study. BMC Pregnancy Childbirth. 2018;18. DOI: https://doi.org/10.1038/s41598-018-29889-3

Indian Council of Medical Research (ICMR). National ART Registry of India Annual Report. New Delhi: ICMR. Available at: https://artsurrogacy. gov.in/pages/national-art-%26-surrogacy-registry. Accessed on 10 November 2025.

Wyns C, De Geyter C, Calhaz-Jorge C, Kupka MS, Motrenko T, Smeenk J, et al. ART in Europe 2022: results generated from European registries by the EIM Consortium for ESHRE. Hum Reprod Open. 2022;2022(3):hoac022.

National Institute for Health and Care Excellence (NICE). Fertility problems: assessment and treatment. NICE guideline CG156. London: NICE; 2013. Available at: https://www.nice.org.uk/guidance/ cg156/evidence/cg156-fertility-full-guideline. Accessed on 10 November 2025.

Seshiah V, Balaji V, Balaji MS, Sanjeevi CB, Green A. Gestational diabetes mellitus in India. J Assoc Physicians India. 2004;52:707-11.