Impact of IVF/ICSI on Grades of Placenta Accreta Spectrum Disorders and Pregnancy Outcomes

Objective To investigate the impact of IVF/ICSI on grades of placenta accreta spectrum disorders and pregnancy outcomes. Methods Placenta accreta spectrum disorders patients who underwent cesarean section at a single clinical center from January 2018 to March 2023 were retrospectively included in this study. Baseline characteristics and outcomes were compared between the IVF/ICSI group and the spontaneous conception group. Binary logistic regression was used to explore the risk factors associated with adverse outcomes related to IVF/ICSI. A 1:1 ratio propensity score matching (PSM) was conducted to minimize selection bias between the two groups. Data analysis was performed using SPSS (version 25.0) software. Results No increase in the incidence of grades placenta was detected for IVF/ICSI group, and the difference is not statistically significant (P = 0.290). PAS grading is not associated with IVF/ICSI (OR = 0.76, 95%CI: 0.45 ~ 1.27, P = 0.290). In contrast, a significant risk factor for postpartum hemorrhage (OR = 9.20, 95%CI: 2.68 ~ 9.22, P < 0.001) and red cells transfusion ≥ 4U (OR = 3.71,95%CI:1.21 ~ 11.33, P = 0.021) was observed in IVF/ICSI group. No additional adverse pregnancy outcomes arose as a result of IVF/ICSI. Conclusion It is necessary to further investigation into the potential risk factors that might impact PAS grading. It has been shown that IVF/ICSI treatment is associated with a higher risk of postpartum hemorrhage and blood transfusion requirements. Therefore, in order to provide patients the best chance of recovery, professionals must carefully evaluate the patient's health as well as the available treatment options.