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The study population was 14,312,619 deliveries between 2017 and 2020. Obstetric characteristics and outcomes associated with GC pregnancies were assessed with inverse probability of treatment weighting propensity score.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>There were 1965 GCs (13.7 per 100,000) included\u00a0for national estimates. The prevalence rate of GC pregnancies increased by 55.0% over a 4-year period from 11.8 to 18.2 per 100,000 deliveries (<jats:italic>P<\/jats:italic>-trend\u2009&lt;\u2009.001). In the weighted model, GCs were more likely to have a multiple gestation pregnancy (14.7% vs 1.8%, adjusted odds ratio [aOR] 7.83, 95% confidence interval [CI] 6.54\u20139.38, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001), placental abruption (3.5% vs 1.1%, aOR 2.98, 95%CI 2.12\u20134.19), and low-lying placenta (1.6% vs 0.2%, aOR 5.14, 95%CI 3.10\u20138.52). Among singleton delivery, odds of late-preterm (10.8% vs 6.4%, aOR 1.79, 95%CI 1.44\u20132.23) and periviable (1.1% vs 0.4%, aOR 2.54, 95%CI 1.32\u20134.89) deliveries and postpartum hemorrhage (12.2% vs 4.1%, aOR 3.27, 95%CI 2.67\u20134.00) were increased for GC compared to non-GCs whereas odds of cesarean delivery (23.6% vs 31.6%, aOR 0.59, 95%CI 0.51\u20130.69) were decreased. These associations were less robust in multi-fetal gestations.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>The results of the current nationwide assessment suggest that GC pregnancies are rare but gradually increasing in the United States. This study shows that GC pregnancies have usually favorable pre-pregnancy patient characteristics compared to non-GC pregnancies, with mixed obstetric outcomes including increased odds of preterm delivery, placental abnormalities, and postpartum hemorrhage and decreased odds of cesarean delivery in singleton pregnancies.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s10815-024-03320-5","type":"journal-article","created":{"date-parts":[[2024,11,20]],"date-time":"2024-11-20T09:38:09Z","timestamp":1732095489000},"page":"201-211","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["National-level assessment of gestational carrier pregnancies in the United States"],"prefix":"10.1007","volume":"42","author":[{"given":"Aaron D.","family":"Masjedi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel S.","family":"Mandelbaum","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine V.","family":"Erickson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zachary S.","family":"Anderson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinya","family":"Matsuzaki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph G.","family":"Ouzounian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6232-8701","authenticated-orcid":false,"given":"Koji","family":"Matsuo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard J.","family":"Paulson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,11,20]]},"reference":[{"key":"3320_CR1","doi-asserted-by":"crossref","unstructured":"Practice Committee of the American Society for Reproductive M, Practice committee of the Society for Assisted Reproductive Technology. 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