Women who carry a baby for other people, known as surrogacy – or, colloquially, as ‘surrogate mothers’ – may be at higher risk of experiencing serious complications during pregnancy and after the baby is born, including high blood pressure. during pregnancy and postpartum hemorrhage, compared to those who conceive unassisted or through in vitro fertilization (IVF), according to new research from ICES and Queen’s University in Canada.
Until now, there was little knowledge about whether gestational carriers and babies are at increased risk of serious health complications both during pregnancy and after delivery. This is one of the first large-scale population-based studies to analyze linked health data sets, comparing health outcomes between three different types of conception: unassisted, in vitro fertilization (IVF), and surrogacy.
The study has been published in the journal Annals of Internal Medicine and its authors analyzed 863,017 singleton births in Ontario, Canada, between 2012 and 2021, all at more than 20 weeks of gestation. The groups included 846,124 (97.6%) conceived unassisted, 16,087 (1.8%) through IVF, and 806 (0.1%) through gestational carriers.
More chances of maternal morbidity in gestational carriers
The researchers evaluated severe maternal morbidity (SMM) and severe neonatal morbidity (SNM), which combine several health indicators for both pregnant people and babies. They also looked at hypertensive disorders (such as preeclampsia), cesarean delivery, premature birth, and postpartum hemorrhage. The main findings of the study were:
- The risk of severe maternal morbidity was 2.3% for the unassisted group, 4.3% for the IVF group, and 7.8% for the surrogacy group.
- The gestational carrier group also showed an increased risk of hypertensive disorders and postpartum hemorrhage when analyzed separately from MMS.
- Although surrogacy was associated with an increased risk of preterm birth (less than 37 weeks’ gestation), no conclusive evidence was found for an increased risk of severe maternal morbidity.
“Health professionals who care for individuals and couples who need a gestational carrier to start their family should inform them about the possible risks during pregnancy and the early postpartum period,” said María Vélez, lead author of the study, associate scientist at ICES. and, at the time of the research, an associate professor in the department of Obstetrics and Gynecology at Queen’s University.
One of the limitations of the study was the lack of information on the reasons why parents chose surrogacy, the sources of egg and sperm donation, the type of IVF used, and the reasons why people decide to be carriers. gestational. Future research could help determine whether these factors have an impact on the health outcomes of both the pregnant woman and the baby.
“Healthcare professionals who care for individuals and couples who need a gestational carrier to start their family should inform them about the possible risks during pregnancy and the early postpartum period.”
Jackie Leach Scully, professor of Bioethics at the University of New South Wales (Australia), who has not participated in the study, has indicated in statements to SMC Spain that, “as the authors point out, although the ideal would be that the gestational carrier was healthy and had a low risk of complications, this does not always happen in practice. “This raises some ethical questions, first of all, about the possible exploitation of women who act as gestational carriers and who, in effect, assume the risks of pregnancy on behalf of another person.”
“Second, the paucity of accurate data on the risks and outcomes of surrogacy should make us question how seriously the health of the woman is taken, as opposed to the health of the fetus or baby. The neglect of women’s health in the history of medicine is well recognized, and can be exacerbated in the situation of surrogacy, where the role of the gestational carrier is socially hidden,” he concludes.
