Evaluation of Maternal and Neonatal Outcomes Among Lebanese Women Conceived Through Assisted Reproductive Technology
试验速览
- 阶段
- 不适用
- 状态
- 进行中（未招募）
- 入组人数
- 1,000
- 试验地点
- 1
- 主要终点
- Percentage of Pregnant Women with Gestational Diabetes Mellitus (GDM) in the Exposed Group versus Non-Exposed Group
研究概览
简要总结
Background: The number of couples experiencing difficulties conceiving and seeking treatment for infertility has increased dramatically over time. Treatment options for infertility have evolved significantly over the past four decades, expanding to include assisted reproductive technologies (ART). However, the impact of ART on pregnancy outcomes remains unclear. Studies have shown that ART pregnancies are associated with a higher risk of maternal and neonatal adverse outcomes compared to those resulting from spontaneous conception. To this date, no comprehensive studies have been conducted in Lebanon to assess this association. Therefore, it is crucial to evaluate whether Lebanese women who conceive via ART are at higher risk for maternal and birth-related complications.
Objective: The aim of this study is to evaluate maternal and neonatal outcomes among women who conceived through assisted reproductive technology (ART), compared to those who conceived via other fertility treatments or naturally, at Dr. Ghazeeri's clinic at the American University of Beirut Medical Center.
Methods: Investigators propose to conduct an observational retrospective cohort study involving all pregnant women treated by Dr. Ghazeeri who delivered at the American University of Beirut Medical Center between 2018 and 2023. Pregnancies exposed to assisted reproductive technology (ART) or other fertility treatments will be matched to a group of spontaneous pregnancies based on propensity scores. The study has been initiated following approval from the Institutional Review Board (IRB) at the American University of Beirut Medical Center. Data analysis will be performed using SPSS version 26.
Expected Results: If no associations are found between ART or other fertility treatments and an increased risk of maternal and neonatal outcomes, the results will provide reassurance for mothers seeking these treatments. However, if associations are identified, policymakers will need to establish comprehensive regulations outlining the appropriate use of these technologies. Additionally, these findings would lay the groundwork for obstetricians to implement closer monitoring and more careful management during pregnancy.
详细描述
i. Study Design Investigators propose to conduct an observational retrospective cohort study on all pregnant women who delivered at Dr. Gahzeeri's clinic at the American University of Beirut Medical Center between 2018 and 2023. Investigators have obtained approval from the Institutional Review Board (IRB) at AUB, which is valid until August 2025.
ii. Sample Size: As this is a retrospective cohort study, the sample size will be determined by the number of participants who meet the inclusion criteria.
iii. Population The patient characteristics will be extracted from the Epic electronic health record system at the hospital. Pregnancies exposed to ART or other fertility treatments will be matched to spontaneous pregnancies based on propensity scores
In this study, the subjects will be divided into two groups:
- Exposed group:
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 20 Years 至 50 Years（Adult）
- 性别
- Female
- 接受健康志愿者
- 是
入选标准
- •All pregnant ladies of Lebanese Nationality only who delivered at the American University of Beirut Medical Center (AUB-MC) between Nov 2018- Nov 2023
- •Pregnancies that were delivered at least 20 weeks of gestation (≥ 20 weeks)
- •All pregnant women who are in procreation age (20-50 years old)
- •For pregnant women by ART: only if ART is done at the AUB-MC
- •Subject's file being accessible for all the three trimesters
- •Subjects being followed up until delivery only at the AUB-MC
- •Subjects whom their baby or babies' records are available (it could be multiples)
排除标准
- •Subjects who started their follow-up after the 1st trimester (missing data before 12 weeks).
- •All subjects with history of severe chronic conditions before gestation such as, pre-existing cancer, heart diseases (coronary artery disease, arrhythmia, cardiac defects, ischemic stroke, venous thromboembolism, liver disease and/or kidney disease, history of nervous system disorders (seizures, depression).
- •Subjects who undergone ART elsewhere
- •Subjects who lost to follow up during their pregnancies (missing data)
- •Moms who delivered outside the AUBMC hospital
结局指标
主要结局
Percentage of Pregnant Women with Gestational Diabetes Mellitus (GDM) in the Exposed Group versus Non-Exposed Group
时间窗: 24-28 weeks of gestation
GDM will be diagnosed using standardized glucose screening tests; Oral Glucose Tolerance Test (OGTT) between 24 and 28 weeks of gestation. One-hour OGTT (after drinking a 50g glucose solution): Different cut-off thresholds are used for the 50-g glucose tolerance screening to be considered an abnormal result, including ≥130 mg/dL , ≥135 mg/dL, and ≥140 mg/dL. * Possible Gestational Diabetes (possible diagnosis if ≥140 mg/dL); and here the patient requires a confirmatory diagnosis which is the three-hours OGTT (after drinking 100g glucose solution): * Normal \<140 mg/dL * Gestational Diabetes ≥140 mg/dL
Percentage of Pregnant Women with Gestational Hypertension in the Exposed Group versus the Non-Exposed Group
时间窗: from 20 weeks + 1 day to 40 weeks of gestation
Gestational hypertension is confirmed when blood pressure greater than or equal to 140mmHg systolic or 90mmHg diastolic on 2 separate occasions at least 4 hours apart after 20 weeks of pregnancy when previous blood pressure was normal
Percentage of Babies Born Preterm to Women in the Exposed Group versus Non-Exposed Group
时间窗: Before 37 weeks of gestation
Preterm is defined as babies born alive before 37 weeks of pregnancy are completed.
Percentage of Babies Born Small for Gestational Age to Women in the Exposed Group versus Non-Exposed Group
时间窗: day one of birth
Infants with a birth weight below the 10th percentile for their gestational age.
Percentage of Babies Born Large for Gestational Age to Women in the Exposed Group versus Non-Exposed Group
时间窗: day one of birth
Infants with a birth weight above the 90th percentile for their gestational age
次要结局
- Percentage of Pregnant Women with Polyhydramnios in the Exposed Group versus Non-Exposed Group(During 40 weeks of gestation)
- Percentage of Pregnant Women with Oligohydramnios in the Exposed Group versus Non-Exposed Group(During 40 weeks of gestation)
研究者
Reva Assem Mosleh
Principal Investigator
Lebanese University