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Association of multifetal gestation with obstetric and neonatal outcomes in gestational carrier pregnancies

  • Assisted Reproduction Technologies
  • Published:
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Abstract

Objective

Multifetal gestation is more frequent among gestational carrier pregnancies than non-surrogacy IVF pregnancies. We aimed to evaluate the association between multifetal gestation and obstetric and neonatal morbidity among gestational carrier pregnancies.

Methods

Pooled cross-sectional study of birth certificate data from gestational carrier pregnancies in Utah from 2009 to 2018. Our primary outcome was a composite of severe obstetric morbidity; secondary outcomes included cesarean delivery (CD), hypertensive disorders of pregnancy, preterm birth (PTB), and a neonatal morbidity composite. Logistic regression was utilized to compare odds of these outcomes between gestational carrier pregnancies with and without multifetal gestation.

Results

A total of 361 gestational carrier pregnancies resulted in the delivery of 435 neonates during the study period. Of these, 284 were singleton pregnancies, and 77 were multifetal, a multifetal gestation rate of 21.3%. Baseline demographic characteristics did not differ between singleton and multifetal gestations. Multifetal gestation was not associated with higher rates of severe obstetric morbidity (odds ratio [OR] 1.87, 95% confidence interval [CI] 0.34–10.39). Multifetal gestation was associated with increased odds of neonatal morbidity (OR 9.49, 95% CI 5.35–15.83); PTB < 37, 34, and 32 weeks (OR 21.88, 95% CI 11.64–41.12; OR 11.67, 95% CI 5.25–25.91; OR 8.79, 95% CI 3.41–22.68); and CD (OR 4.82, 95% CI 2.81–8.27).

Conclusion

Severe obstetric morbidity did not differ between singleton and multifetal gestations among gestational carrier pregnancies. However, multifetal gestation was associated with increased odds of neonatal morbidity, CD, and PTB. This information may be useful when counseling prospective gestational carriers and intended parents.

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Data availability

With the approval of the State of Utah Department of Health Office of Vital Records and Statistics, we will provide our data if requested.

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Acknowledgements

The study team would like to thank Ms. Yanling Shi with the Utah Department of Health Office of Vital Records and Statistics for her help providing and interpreting birth certificate data.

Author information

Authors and Affiliations

  1. Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco, 550 16th St, San Francisco, CA, 94158, USA

    Kate Swanson & Miriam Kuppermann

  2. Division of Medical Genetics, Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA

    Kate Swanson

  3. Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, University of Utah Health, Salt Lake City, UT, USA

    Michelle Debbink & Brett D. Einerson

  4. University of Utah Center for Reproductive Medicine, Salt Lake City, UT, USA

    Joseph M. Letourneau

  5. Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA

    Miriam Kuppermann

Authors
  1. Kate Swanson
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  2. Michelle Debbink
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  3. Joseph M. Letourneau
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  4. Miriam Kuppermann
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  5. Brett D. Einerson
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Contributions

All authors contributed to the study conception and design. Data analysis was performed by the first and second authors. The first draft of the manuscript was written by the first author. All authors read and approved the final manuscript prior to submission.

Corresponding author

Correspondence to Kate Swanson.

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Conflicts of interest/competing interests

No authors have conflicts of interest or competing interests to disclose.

Ethics approval

This study was approved by the State of Utah Department of Health Office of Vital Records and Statistics.

Consent to participate

As only deidentified, publicly available birth certificate data was utilized, no consent to participate was obtained.

Consent for publication

As only deidentified, publicly available birth certificate data was utilized, no consent for publication was obtained.

Code availability

All statistical analysis was performed using Stata version 15.1 (StataCorp LLC, College Station, TX).

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Swanson, K., Debbink, M., Letourneau, J.M. et al. Association of multifetal gestation with obstetric and neonatal outcomes in gestational carrier pregnancies. J Assist Reprod Genet 38, 661–667 (2021). https://doi.org/10.1007/s10815-020-02034-8

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  • DOI: https://doi.org/10.1007/s10815-020-02034-8

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