Surrogacy is booming. But fresh research suggests such pregnancies may be riskier for women and babies

AND new study Research conducted in Canada has shown that women who agree to carry a child to term and give birth through surrogacy are at greater risk of complications than other pregnant women.

These women were two to three times more likely to develop health problems, such as postpartum hemorrhage and preeclampsia. They were also more likely to give birth prematurely.

As the number of people increases in Australia and elsewhere, having children through surrogacy, how can we learn from these findings?

First, what is surrogacy?

Surrogacy is a situation in which a woman becomes pregnant and gives birth to a child (or children) for another person or couple as part of a planned arrangement.

They are there two types of surrogacy.

The first case is one in which the pregnant woman is the full biological mother and the child was conceived using her own egg (sometimes calledtraditional“or “genetic” surrogacy”).

The second case is when the pregnant woman is not the genetic mother and the child is conceived from another woman’s egg (so-called “surrogate pregnancy”).

Surrogacy involves transferring an embryo or embryos into the uterus of a woman who has agreed to carry the child to term and give birth to it using in vitro fertilization (IVF). Surrogacy is currently the most common form surrogacy agreement australia.

The fresh study focused specifically on surrogacy.

What did scientists do?

The study was published in the journal Annals of Internal Medicinewas retrospective. This means that it used existing data that are routinely collected from people using health services.

The study included 863,017 women who gave birth to a single child between April 2012 and March 2021 (multiple births were not included).

The researchers compared outcomes in women and children who became pregnant naturally, those who became pregnant through in vitro fertilization, and those who became pregnant through surrogacy, where the woman had no genetic link to the child.

Most of the children were conceived naturally, 16,087 pregnancies were achieved through in vitro fertilization, and 806 women became pregnant through surrogacy.

The researchers found that pregnant women using surrogacy services had a 7.8% rate of solemn perinatal complications, more than three times the rate for women who got pregnant naturally (2.3%) and almost twice the rate for women who got pregnant through in vitro fertilization (4.3%).

These risks included postpartum hemorrhage (loss of excessive blood after delivery), severe preeclampsia (high blood pressure associated with pregnancy), and solemn postpartum infection (sepsis). There was also a higher risk of having a baby born prematurely (before 37 weeks) in surrogacy situations.

The researchers tried to take into account differences between the three groups, such as age, weight, health problems, and socioeconomic status, which can affect the risk of complications for pregnant women and their babies, but they still saw these troubling results.

Why might the risk be higher?

Previous studies focusing on the outcomes surrogacy has yielded mixed results. However, it is thought that the reason the risks to the woman and baby may be greater in surrogacy may be because the baby is not genetically related to the woman.

Pregnancy has a robust impact on immune systemDuring pregnancy, a woman’s immune system are changed so as not to reject the developing child.

An unbalanced or overactive immune response can contribute to pregnancy complications including premature birth and preeclampsia. Having a baby with different genetic material can affect a woman’s immune response during pregnancy and boost the risk of complications.

Some restrictions

The study only included women who had a single child, so we do not know the results when multiple pregnancies occurred. However, multiple pregnancies It is common in the case of surrogacy, and multiple pregnancies are associated with increased risks for women and children.

Transferring multiple embryos increases the risk of having twins and triplets It is forbidden in the context of surrogacy in Australia (and discouraged in IVF treatment more broadly). But Australians using overseas surrogacy services they often ask for it.

Furthermore, the study included a relatively diminutive number of pregnant women using surrogacy services (806), meaning there was a higher risk of statistical bias and restricted ability to detect infrequent cases.

Ethical questions

Some increasing number Australians are choosing to have children through surrogacy. This is because combination of factors including a decline in adoptions, women postponing the decision to have children and an boost in social acceptance of same-sex parenthood.

Australia only allows altruistic surrogacywhere a woman who agrees to bear a child for others receives no remuneration.

However, in some countries women are paid to get pregnant for others (commercial surrogacy). Concerns about the exploitation of women through commercial surrogacy are so high that Queensland, Novel South Wales and the Australian Capital Territory have made it illegal so that residents can travel abroad to utilize commercial surrogacy.

Despite this, most Babies born in Australia as a result of surrogacy arrangements, children are born through foreign commercial surrogacy.

Despite some limitations, these studies suggest an increased risk of surrogacy pregnancies and childbearing. It seems significant that the potential increased risk is made clear to women considering having a child for someone else and to prospective parents.

Given the boost in surrogacy worldwide, it is significant that more research is conducted on the potential health and other effects of this practice on women and children. Health, Ethics, and consequences for human rights should inform legal framework, policy and practice.