Parental health status and infant outcomes: Upstate KIDS Study

Infertility, now defined to be a disease, was associated with smaller infant size particularly when defining it as duration at risk for pregnancy, as were other parental chronic diseases.

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Volume 109, Issue 2, Pages 315–323


Germaine M. Buck Louis, Ph.D.'Correspondence information about the author Ph.D. Germaine M. Buck LouisEmail the author Ph.D. Germaine M. Buck Louis, Erin Bell, Ph.D., Yunlong Xie, Ph.D., Rajeshwari Sundaram, Ph.D., Edwina Yeung, Ph.D.



To assess parental health status inclusive of infertility and infant outcomes.


Birth cohort with cross-sectional analysis of parental health status and infant outcomes.


Not applicable.


Parents (n = 4,886) and infants (n = 5,845) participating in the Upstate KIDS birth cohort.



Main Outcome Measure(s)

Infertility was defined as [1] sexually active without contraception for 1+ years without pregnancy, [2] ever requiring ≥12 months to become pregnant, and [3] requiring ≥12 months for index pregnancy. Multivariable linear regression with generalized estimating equations estimated the change (β coefficient and 95% confidence interval [CI]) in infant outcomes (gestation, birthweight, length, head circumference, ponderal index) and relative to each disease, including infertility after adjusting for age, body mass index, and infertility treatment.


Prevalence of parental chronic diseases ranged from <1% to 19%, and 21% to 54% for infertility. Maternal hypertension was negatively associated with gestation (β, −0.64; 95% CI, −1.03, −0.25) and birthweight (−151.98; −262.30, −41.67) as was asthma and birthweight (−75.01; −130.40, −19.62). Maternal kidney disease was associated with smaller head circumference (−1.09; −2.17, −0.01), whereas paternal autoimmune disease was associated with larger head circumference (0.87; 0.15, 1.60). Infertility was negatively associated with birthweight (−62.18; −103.78, −20.58), length (−0.33; −0.60, −0.06), and head circumference (−0.35; −0.67, −0.03).


Infertility was significantly associated with reduced infant size even after accounting for infertility treatment, although the magnitude of reduction varied by definition of infertility. Absence of pregnancy within a year of being at risk may be informative about health.

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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. 


Go to the profile of Mary Samplaski
almost 4 years ago

With the known shift in parental age (ie, men are having children later in life), did the authors look at if any of these trends were associated with increasing parental age?