| Author | Lodge-Tulloch, Nakeisha A. | |
| Author | Elias, Flávia Tavares Silva | |
| Author | Pudwell, Jessica | |
| Author | Gaudet, Laura | |
| Author | Walker, Mark | |
| Author | Smith, Graeme N. | |
| Author | Velez, Maria P. | |
| Access date | 2021-07-12T12:32:13Z | |
| Available date | 2021-07-12T12:32:13Z | |
| Document date | 2021 | |
| Citation | LODGE-TULLOCH, Nakeisha A. et al. Caesarean section in pregnancies conceived by assisted reproductive technology: a systematic review and meta-analysis. BMC Pregnancy and Childbirth, [s.l.], v. 21, n. 244, p.1-13, 2021. | pt_BR |
| ISSN | 1471-2393 | pt_BR |
| URI | https://www.arca.fiocruz.br/handle/icict/48120 | |
| Sponsorship | Canadian Institutes of Health Research
(CIHR) / Institute of Human Development, child and Youth Health (IHDCYH) /
Clinician Investigators Program, Grant number MFM – 146444. | pt_BR |
| Language | eng | pt_BR |
| Publisher | BMC part of Springer Nature | pt_BR |
| Rights | open access | pt_BR |
| MeSH | Fertilization in Vitro | pt_BR |
| MeSH | Cesarean Section | pt_BR |
| MeSH | Systematic Review | pt_BR |
| Title | Caesarean section in pregnancies conceived by assisted reproductive technology: a systematic review and meta-analysis | pt_BR |
| Type | Article | pt_BR |
| DOI | 10.1186/s12884-021-03711-x | |
| Abstract | Background: Caesarean section rates are higher among pregnancies conceived by assisted reproductive technology
(ART) compared to spontaneous conceptions (SC), implying an increase in neonatal and maternal morbidity. We aimed
to compare caesarean section rates in ART pregnancies versus SC, overall, by indication (elective versus emergent), and
by type of ART treatment (in-vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), fresh embryo transfer, frozen
embryo transfer) in a systematic review and meta-analysis.
Methods: We searched Medline, EMBASE and CINAHL databases using the OVID Platform from 1993 to 2019, and the
search was completed in January 2020. The eligibility criteria were cohort studies with singleton conceptions after in vitro fertilization and/or intracytoplasmic sperm injection using autologous oocytes versus spontaneous conceptions.
The study quality was assessed using the Newcastle Ottawa Scale and GRADE approach. Meta-analyses were
performed using odds ratios (OR) with a 95% confidence interval (CI) using random effect models in RevMan 5.3, and I squared (I2
) test > 75% was considered as high heterogeneity.
Results: One thousand seven hundred fifty studies were identified from the search of which 34 met the inclusion
criteria. Compared to spontaneous conceptions, IVF/ICSI pregnancies were associated with a 1.90-fold increase of odds
of caesarean section (95% CI 1.76, 2.06). When stratified by indication, IVF/ICSI pregnancies were associated with a 1.91-
fold increase of odds of elective caesarean section (95% CI 1.37, 2.67) and 1.38-fold increase of odds of emergent
caesarean section (95% CI 1.09, 1.75). The heterogeneity of the studies was high and the GRADE assessment moderate
to low, which can be explained by the observational design of the included studies. Conclusions: The odds of delivering by caesarean section are greater for ART singleton pregnancies compared to
spontaneous conceptions. Preconception and pregnancy care plans should focus on minimizing the risks that may
lead to emergency caesarean sections and finding strategies to understand and decrease the rate of elective caesarean
sections. | pt_BR |
| Affilliation | Queen’s University. Kingston General Hospital. Department of Obstetrics and Gynecology. Kingston, ON, Canada. | pt_BR |
| Affilliation | Queen’s University. Kingston General Hospital. Department of Obstetrics and Gynecology. Kingston, ON, Canada / Fundação Oswaldo Cruz. Fiocruz Brasília. Programa de Evidências para Políticas e Tecnologias de Saúde. Brasília, DF, Brasil. | pt_BR |
| Affilliation | Queen’s University. Kingston General Hospital. Department of Obstetrics and Gynecology. Kingston, ON, Canada. | pt_BR |
| Affilliation | Queen’s University. Kingston General Hospital. Department of Obstetrics and Gynecology. Kingston, ON, Canada. | pt_BR |
| Affilliation | University of Ottawa. Department of Obstetrics, Gynecology & Newborn Care. Ottawa, ON, Canada. | pt_BR |
| Affilliation | Queen’s University. Kingston General Hospital. Department of Obstetrics and Gynecology. Kingston, ON, Canada. | pt_BR |
| Affilliation | Queen’s University. Department of Public Health Sciences. Kingston, ON, Canada / Queen’s University. Kingston General Hospital. Department of Obstetrics and Gynecology. Kingston, ON, Canada | pt_BR |
| Subject | Elective caesarean section | pt_BR |
| Subject | Emergent caesarean section | pt_BR |
| Subject | Frozen embryo transfer | pt_BR |
| Subject | Fresh embryo transfer | pt_BR |
| Subject | In vitro fertilization | pt_BR |
| Subject | Intracytoplasmic sperm injection | pt_BR |
| Subject | Maternal outcomes | pt_BR |
| DeCS | Cesárea | pt_BR |
| DeCS | Fertilização In Vitro | pt_BR |
| DeCS | Estruturas Embrionárias | pt_BR |
| DeCS | Embrião de Mamíferos | pt_BR |
| DeCS | Revisão Sistemática | pt_BR |
