Obstetric and perinatal complications associated with assisted reproductive treatment in Spain

  • Ana Ballesta-Castillejos
  • Juan Gomez-Salgado
  • Julian Rodriguez-AlmagroEmail author
  • Inmaculada Ortiz-Esquinas
  • Antonio Hernández-Martínez
Assisted Reproduction Technologies



Although most newborns conceived through assisted reproductive treatments are healthy, there are concerns about the safety of reproductive techniques and their effect on foetal/maternal well-being.


This study aims to describe the incidence of obstetric and perinatal complications in women undergoing assisted reproductive treatments in the Spanish Health System.


This is a cross-sectional observational study aimed at women who have been mothers between 2013 and 2018 in Spain. The data was collected through an online survey of 42 items that was distributed through lactation associations and postpartum support groups. In the data analysis, crude odds ratios (OR) and adjusted odds ratios (AOR) were calculated, through a multivariate analysis with binary logistic regression and multinomial logistic regression.


Five thousand nine hundred forty-two women participated, 2.3% (139) through artificial insemination and 8.2% (486) through in vitro fertilisation (IVF) techniques. Women who underwent IVF had a higher likelihood of suffering problems during pregnancy (OR = 1.71; 95% confidence intervals (95% CI), 1.37–2.13), delivery (OR = 1.43; 95% CI, 1.01–2.02), and postpartum (OR = 1.94; 95% CI, 1.40–2.69) than women with spontaneous pregnancy. No increased likelihood of neonatal problems was observed in this group except for twin pregnancy (OR = 9.17; 95% CI, 6.02–13.96) and prematurity (OR = 1.43; 95% CI, 1.01–2.02). No differences were observed between spontaneous pregnancies and those achieved by artificial insemination.


Pregnancies achieved through IVF present a higher risk of complications before, during and after delivery. However, there is no increased risk of neonatal problems except for a higher likelihood of twin pregnancy and prematurity.


Reproductive techniques assisted Fertilization in vitro Quality of health care Patient safety Obstetric labour complications Morbidity 



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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyHospital Nuestra Señora Del PradoToledoSpain
  2. 2.Department of Sociology, Social Work and Public HealthUniversity of HuelvaHuelvaSpain
  3. 3.Safety and Health Postgraduate ProgrammeUniversidad Espíritu SantoGuayaquilEcuador
  4. 4.Department of Nursing, Ciudad Real Nursing SchoolUniversity of Castilla-La ManchaCiudad RealSpain
  5. 5.Department of Obstetrics and GynecologyMancha-Centro HospitalCiudad RealSpain

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