Adverse pregnancy and birth outcomes associated with underlying diagnosis with and without assisted reproductive technology treatment

Women with infertility-related diagnoses had an excess of perinatal morbidity even in the absence of assisted reproductive technology treatment.

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Authors

Judy E. Stern, Ph.D., Barbara Luke, Sc.D., M.P.H., Michael Tobias, M.S., Daksha Gopal, M.P.H., Mark D. Hornstein, M.D., Hafsatou Diop, M.D., M.P.H.

Volume 103, Issue 6, Pages 1438-1445

Abstract

Objective:

To compare the risks for adverse pregnancy and birth outcomes by diagnoses with and without assisted reproductive technology (ART) treatment to non-ART pregnancies in fertile women.

Design:

Historical cohort of Massachusetts vital records linked to ART clinic data from Society for Assisted Reproductive Technology Clinic Outcome Reporting System.

Setting:

Not applicable.

Patient(s):

Diagnoses included male factor (ART only), endometriosis, ovulation disorders, tubal (ART only), and reproductive inflammatory disorders (non-ART only). Pregnancies resulting in singleton and twin live births from 2004 to 2008 were linked to hospital discharges in women who had ART treatment (n = 3,689), women with no ART treatment in the current pregnancy (n = 4,098), and non-ART pregnancies in fertile women (n = 297,987).

Intervention(s):

None.

Main Outcome Measure(s):

Risks of gestational diabetes, prenatal hospitalizations, prematurity, low birth weight, and small for gestational age were modeled using multivariate logistic regression with fertile deliveries as the reference group adjusted for maternal age, race/ethnicity, education, chronic hypertension, diabetes mellitus, and plurality (adjusted odds ratios [AORs] and 95% confidence intervals [CIs]).

Result(s):

Risk of prenatal hospital admissions was increased for endometriosis (ART: 1.97, 1.38–2.80; non-ART: 3.34, 2.59–4.31), ovulation disorders (ART: 2.31, 1.81–2.96; non-ART: 2.56, 2.05–3.21), tubal factor (ART: 1.51, 1.14–2.01), and reproductive inflammation (non-ART: 2.79, 2.47–3.15). Gestational diabetes was increased for women with ovulation disorders (ART: 2.17, 1.72–2.73; non-ART: 1.94, 1.52–2.48). Preterm delivery (AORs, 1.24–1.93) and low birth weight (AORs, 1.27–1.60) were increased in all groups except in endometriosis with ART.

Conclusion(s):

The findings indicate substantial excess perinatal morbidities associated with underlying infertility-related diagnoses in both ART-treated and non-ART-treated women.

Read the full text at: http://www.fertstert.org/article/S0015-0282(15)00157-0/fulltext


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. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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