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A recent study has revealed alarming health risks faced by women who act as gestational carriers, or surrogate mothers, during and after pregnancy. The study, published on September 24 in the Annals of Internal Medicine, highlights a significantly increased likelihood of severe maternal complications compared to women carrying their own pregnancies.
Researchers from McGill University in Canada led this large cohort study, analyzing over a decade of data from the Better Outcomes Registry & Network (BORN) Ontario database. This data represents more than 99% of births in Ontario, providing valuable insights into the health outcomes of surrogates compared to traditional pregnancies.
Surrogate Mothers Face Higher Health Risks
The study examined 863,017 singleton births, including 806 from gestational carriers. It found that surrogates experienced severe maternal morbidity (SMM) at a rate of 7.8%, which is more than three times higher than for women who conceived naturally and nearly twice as high as for women who conceived via in vitro fertilization (IVF). Severe maternal morbidity refers to life-threatening complications during pregnancy, childbirth, or postpartum, such as severe postpartum hemorrhage, preeclampsia, and puerperal sepsis.
Surrogates were also more likely to give birth prematurely, further increasing health risks for both mother and child. The study identified a slightly elevated risk of neonatal complications in gestational carrier pregnancies compared to traditional pregnancies.
Demographic Factors and Risks
The study noted that gestational carriers tended to differ demographically from those in traditional pregnancies. Surrogates were more likely to have given birth previously, live in lower-income areas, and have higher rates of obesity and chronic hypertension. Additionally, surrogates tended to be older and nonsmokers when compared with women who conceived naturally, but these trends varied when compared to IVF recipients.
Despite accounting for factors such as age, income, and pre-existing conditions, surrogates still faced a higher risk of severe complications. This highlights that being a gestational carrier itself carries inherent medical risks, independent of other health or lifestyle factors.
Implications for Surrogacy Programs and Future Research
These findings underscore the need for greater caution in the selection of gestational carriers and more comprehensive medical care plans to address their unique risks. The researchers suggest that the surrogate population should receive tailored prenatal care to mitigate potential complications.
“This study is crucial in understanding the heightened risks faced by gestational carriers. As surrogacy becomes more common, it’s essential to ensure that these women are supported with specialized medical care,” said Dr. Maria Velez, the study’s lead author.
While the findings provide important insights, the researchers called for additional studies to explore the biological mechanisms that might explain the increased risks associated with surrogacy. Further research could help refine medical protocols to protect both surrogates and the babies they carry.
For those considering surrogacy, this study serves as an important reminder to weigh the potential health risks and ensure that comprehensive medical evaluations and care are in place throughout the pregnancy journey.
Reference:
“Severe Maternal and Neonatal Morbidity Among Gestational Carriers: A Cohort Study” by Maria P. Velez, MD, PhD, Marina Ivanova, BSc, Jonas Shellenberger, MSc, Jessica Pudwell, MSc, MPH, and Joel G. Ray, MD, MSc. Published on September 24, 2024, in the Annals of Internal Medicine. DOI: 10.7326/M24-0417.
