A Comparative Analysis of Prenatal Screening Choices: ART versus Natural Conception

Corresponding author: ZHAO Yueshu, zyswr@163.com

DOI: 10.12201/bmr.202512.00015

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  Abstract: Background: In clinical practice, women with pregnancies achieved through Assisted Reproductive Technology (ART) often face confusion regarding the choice of prenatal screening methods. There is ongoing clinical debate on whether ART pregnancies warrant a different prenatal screening pathway compared to naturally conceived pregnancies and how to determine the optimal strategy.Objective To analyze the differences in prenatal screening methods, high-risk rates of various screening methods such as nuchal translucency (NT), maternal serum screening (MSS, Downs screening, Downs test), and non-invasive prenatal testing (NIPT), and the prenatal diagnosis rates between ART pregnant women and natural pregnant women. This is to provide more accurate and efficient prenatal screening plans for ART pregnant women.Methods A total of 42,332 singleton pregnant women who delivered at the Third Affiliated Hospital of Zhengzhou University from January 2021 to December 2024 were selected as the research subjects. They were divided into the ART pregnancy group (1,858 cases) and the natural pregnancy group (40,474 cases) based on the mode of conception. The examination rates of NT, Downs screening, and NIPT, as well as the high-risk rates and prenatal diagnosis rates of the two groups of pregnant women were retrospectively analyzed. The differences between the two groups were compared using the χ2 test or Fishers exact probability method, with P < 0.05 considered statistically significant.Results The NT examination rate in the ART group (88.43%) was significantly higher than that in the natural pregnancy group (82.30%). Among non-elderly women, the NIPT examination rate in the ART group (37.19%) was significantly higher than that in the natural pregnancy group (20.14%), while the Downs screening examination rate was significantly lower (64.21% vs. 76.83%). Among elderly women, the NIPT examination rate in the ART group (42.79%) was also significantly higher than that in the natural pregnancy group (30.72%). The NT thickening rate, high-risk rate of Downs screening, and high-risk rate of NIPT in the ART group were 0.79%, 6.93%, and 1.01%, respectively, while those in the natural pregnancy group were 0.60%, 7.44%, and 0.97%, respectively. Comparisons between the two groups showed no statistically significant differences.Conclusion Women with ART pregnancies demonstrate a greater emphasis on prenatal screening, opting for more precise and efficient screening methods and showing heightened concern for offspring safety. Furthermore, the positive rate of prenatal screening in the ART group was not significantly increased, indicating that ART technology itself does not elevate the risk of fetal chromosomal abnormalities.

  Key words: ART; NT; Maternal; Serum Screening; NIPT

  Submit time: 4 December 2025

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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