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People who are gestational carriers (also known as “surrogates”) may be more vulnerable to serious complications during pregnancy and the postpartum period, including high blood pressure during pregnancy and postpartum hemorrhage, compared with people who conceive naturally or through IVF, according to new research. New research from ICES and Queen’s University.
People who are not otherwise able to conceive are assisted to become pregnant by conception carriers, who also carry their offspring. It is unclear whether newborns and conception carriers are more likely to have serious health consequences during pregnancy and after delivery. One of the first significant population-based studies to compare health outcomes for three different methods of conception – unassisted, in vitro fertilization (IVF) and conception carrier – has examined linked health databases.
Research shows that women face serious complications during conception
Lead author Dr. Maria Velez, who is an adjunct scientist at ICES and at the time of the study was an associate professor in the Department of Obstetrics and Gynecology at Queen’s University, says, “This study was undertaken due to the increase in the use of gestational carriers worldwide and the lack of knowledge about the impact of this reproductive method on pregnancy outcomes for gestational carriers and offspring.” Velez is currently an associate professor and physician scientist at the Research Institute of McGill University and the McGill University Health Centre (RI-MUHC).
The study, published in the journal Annals of Internal Medicine, included 863,017 singleton births at more than 20 weeks’ gestation in Ontario, Canada, between 2012 and 2021. The groups included 846,124 (97.6%) that were conceived without assistance, 16,087 (1.8%) by IVF, and 806 (0.1%) using a conception carrier. The researchers analysed severe maternal morbidity (SMM) and severe neonatal morbidity (SNM), which combine several different health indicators for both birth mothers and babies. They also assessed hypertensive disorders (such as pre-eclampsia), cesarean delivery, premature birth and postpartum haemorrhage.
One limitation of the study was that there was a lack of information about why a gestational carrier was chosen by the prospective parents, the egg and sperm donor sources, the type of IVF used, and the reasons people chose to become a gestational carrier. Future research could help assess whether any of these factors would affect the health outcomes of the pregnant person or the baby. “Clinicians involved in the care of individuals and couples who need a gestational carrier to create their family should counsel their patients and gestational carriers about the potential risks during the early stages of pregnancy and delivery,” says Velez.
“There are guidelines regarding eligibility criteria to minimize the risk of pregnancy complications among gestational carriers,” she adds. “However, these guidelines are not always strictly followed.” The study, “Severe maternal and neonatal morbidity among gestational carriers: a cohort study,” was published in the Annals of Internal Medicine.
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