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Surrogacy and Pregnancy

Phillips, Amy M. MD*; Magann, Everett F. MD; Whittington, Julie R. MD; Whitcombe, Dayna D. MD§; Sandlin, Adam T. MD*

Obstetrical & Gynecological Survey: September 2019 - Volume 74 - Issue 9 - p 539–545
doi: 10.1097/OGX.0000000000000703

Importance Surrogacy allows for parenthood when it is otherwise impossible or exceedingly difficult; however, the risks of surrogate pregnancy for the gestational surrogate and the fetus are not well defined.

Objective The aim of this study was to review the literature to examine the prevalence and requirements of surrogate pregnancy and maternal and perinatal outcomes.

Evidence Acquisition A CINAHL and 2 PubMed searches were undertaken using the terms “surrogate mothers” OR “(surrogate or surrogacy)” AND “(mothers OR pregnancy OR pregnant).” The second search used these terms and pregnancy outcomes. The search was limited to the English language, but the years searched were unlimited.

Results The search identified 153 articles, 36 of which are the basis for this review. The number of surrogate pregnancies is increasing in the United States. Fetal risks associated with surrogacy include low birth weight, increased risk of multiple gestation, and preterm birth. Maternal complications associated with surrogate pregnancy include hypertensive disorders of pregnancy, postpartum hemorrhage, and gestational diabetes.

Conclusions and Relevance Surrogacy is a route to parenting that is not without risk to the surrogate or the fetus, and surrogate pregnancy is increasing in frequency in the United States.

Target Audience Obstetricians and gynecologists, family physician.

Learning Objectives After completing this activity, the learner should be better able to identify candidates for surrogacy; describe the effects of obesity on surrogacy; and explain the maternal and perinatal complications associated with surrogate pregnancy.

*Assistant Professor


MFM Fellow

§Resident, Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, AR

All authors, faculty, and staff in a position to control the content of this CME activity and their spouses/life partners (if any) have disclosed that they have no financial relationships with, or financial interests in, any commercial organizations relevant to this educational activity.

Correspondence requests to: Everett F. Magann, MD, University of Arkansas for the Medical Sciences, 4301 W Markham St, Little Rock, AR 72055. E-mail:

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