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Introduction: Previous studies have shown an increased risk of obstetric complications in pregnancies after oocyte donation (OD). The present study includes all singletons born after OD over 10 years in Sweden.Material and Methods: This was a retrospective population-based cohort study. Data from all Swedish in vitro fertilization (IVF) clinics between 2003 and 2012 were collected. Data were cross-linked with the Swedish Medical Birth Registry. The study included 388 OD singletons, 26 696 IVF/ICSI singletons and 999 804 spontaneously conceived (SC) singletons. An adjusted odds ratio (aOR) was calculated with adjustment for relevant confounders.Results: Singleton OD pregnancies had a significantly increased risk of preeclampsia compared with IVF (aOR 3.05; 95% CI 2.23-4.16) and SC (aOR 2.84; 95% CI 2.10-3.84), and increased risk of postpartum hemorrhage (>1000 mL) compared with IVF (aOR 2.66; 95% CI 2.04-3.49) and SC (aOR 2.87; 95% CI 2.20-3.71), a higher risk of preterm birth (<37 weeks) compared with IVF (aOR 1.79; 95% CI 1.30-2.46) and SC (aOR 1.58; 95% CI 1.15-2.16) and a higher risk of low birthweight (<2500 g) compared with IVF (aOR 1.67; 95% CI 1.15-2.42) and SC (aOR 1.46; 95% CI 1.01-2.11). The rate of large-for-gestational age was significantly increased in singletons born after OD with frozen cycles than with fresh cycles (odds ratio 5.29, 95% CI 1.30-21.54).Conclusions: Singleton pregnancies conceived after OD are associated with increased maternal and perinatal risks compared with IVF/ICSI pregnancies using the woman's own oocytes and with SC. [ABSTRACT FROM AUTHOR]