Supplementary Material for: Fetal growth velocity according to the mode of assisted conception

Introduction: Pregnancies conceived through assisted reproductive techniques (ART) are on the rise worldwide and have been associated with a higher risk of placental related disease in the third trimester. Objective: To compare fetal growth velocity between pregnancies through ART and those spontaneously conceived, considering the origin of the selected oocyte (i.e. autologous or donated). Methods: A cohort was created of singleton pregnancies after assisted reproduction, admitted at our institution for delivery, between January 2020 and August 2022. Fetal growth velocity from the second trimester to delivery was compared against a gestational-age-matched group of pregnancies spontaneously conceived according to the origin of the selected oocyte. Results: 125 singleton pregnancies conceived through ART were compared to 315 singleton spontaneous conceptions. Overall, after adjusting for possible confounders, multivariate analysis demonstrated that ART pregnancies had a significantly lower EFW z-velocity from the second trimester to delivery (adjusted mean difference=-0.002; p=0.035) and a higher frequency of EFW z-velocity in the lowest decile (adjusted OR=2.32 [95%CI 1.15-4.68]). Also, when ART pregnancies were compared according to the type of oocyte, those conceived with donated oocytes showed a significantly lower EFW z-velocity from the second trimester to delivery (adjusted mean difference=-0.008; p=0.001) and a higher frequency of EFW z-velocity in the lowest decile (adjusted OR=5.33 [95%CI 1.34-21.5]). Conclusions: Pregnancies achieved through ART exhibit a pattern of lower growth velocity across the third trimester, especially those conceived with donated oocytes. The former represents a sub-group at the highest risk of placental dysfunction that may warrant closer follow-up.引言：全球范围内，辅助生殖技术（Assisted Reproductive Techniques, ART）受孕的妊娠呈上升趋势，且与妊娠晚期胎盘相关疾病的风险显著升高。 研究目的：本研究旨在对比辅助生殖技术受孕与自然受孕的胎儿生长速度，并考量所选用卵母细胞的来源（即自体卵母细胞或供体卵母细胞）。 研究方法：本研究纳入2020年1月至2022年8月期间在本机构分娩的辅助生殖单胎妊娠作为研究队列。根据所选用卵母细胞来源，将该队列中胎儿自妊娠中期至分娩的估计胎儿体重（Estimated Fetal Weight, EFW）z评分生长速度，与胎龄匹配的自然受孕妊娠组进行对比。 研究结果：本研究共纳入125例辅助生殖受孕单胎妊娠产妇，与315例自然受孕单胎妊娠产妇作为对照。总体而言，校正潜在混杂因素后，多因素分析结果显示，辅助生殖技术受孕的妊娠，其自妊娠中期至分娩的EFW z评分生长速度显著更低（校正均数差值=-0.002；p=0.035），且EFW z评分生长速度处于最低十分位数的频率更高（校正优势比（Odds Ratio, OR）=2.32，95%置信区间（95% Confidence Interval, 95%CI）1.15-4.68）。此外，按卵母细胞类型对辅助生殖妊娠进行分组对比后发现，使用供体卵母细胞受孕的产妇，其胎儿自妊娠中期至分娩的EFW z评分生长速度显著更低（校正均数差值=-0.008；p=0.001），且EFW z评分生长速度处于最低十分位数的频率更高（校正优势比OR=5.33，95%置信区间1.34-21.5）。 研究结论：辅助生殖技术受孕的妊娠，其妊娠晚期胎儿生长速度呈降低趋势，尤以使用供体卵母细胞受孕的妊娠最为显著。该类亚组胎盘功能不全风险最高，可能需要更密切的随访监测。