Influencia de la fecundación in vitro en los resultados maternos y neonatales en mujeres con edad materna avanzada
Palabras clave:
Embarazo, Edad Materna, Morbilidad, Resultado del Embarazo, Técnicas Reproductivas, Fertilización in VitroResumen
Establecer el efecto de la fecundación in vitro en la frecuencia de complicaciones maternoneonatales en gestantes con edad mayor o igual de 40 años. Métodos: Casos y controles anidados en cohorte, con recogida de datos retrospectiva y seguimiento prospectivo. Cohorte total de 207 gestantes. Casos o subcohorte con fecundación in vitro y grupo control con gestación espontánea. Se realizaron pruebas paramétricas y no paramétricas para determinar la asociación potencial entre las variables.
Resultados: Las mujeres que lograron su gestación mediante fecundación in vitro tuvieron una edad media mayor (p = 0,03). En los casos fue más frecuente la primiparidad (44,4 % vs. 22,2 %, p = 0,02), la tasa de diabetes gestacional RR = 2,83 (IC
95 %: 1,19-6,77; p = 0,023) y la tasa de cesáreas (p = 0,05). En las gestaciones espontáneas se observó mayor frecuencia de inicio de trabajo de parto espontáneo (56,86 % vs. 37,03 %, p = 0,019). No se encontraron diferencias en la prevalencia de diabetes pregestacional, estados hipertensivos del embarazo, prematuridad, restricción de crecimiento intrauterino, macrosomía fetal, test de Apgar, pH patológico, ingresos neonatales y hemorragia posparto. La tasa de mortalidad perinatal fue mayor en el grupo con gestación lograda mediante fecundación in vitro. Conclusión: La concepción por fecundación in vitro en una población gestante con edad materna avanzada confiere un riesgo añadido a la misma en los resultados adversos maternos y neonatales.
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