OBJECTIVE: To determine whether adverse perinatal outcomes are increased in subfertile women. DESIGN: Cohort study. SETTING: Two tertiary assisted reproductive technologies (ART) centers; Victorian births register. PATIENT(S): Records of women who registered with the clinics (1991-2000), but did not have an infant using ART, were linked to the birth register (1991-2004) to identify singleton non-ART births within 5 years of registration (N = 2171). Controls, matched by maternal age and year of infant's birth, were selected randomly from birth records (N = 4363). INTERVENTIONS: None. MAIN OUTCOME MEASURE(S): Adverse obstetric and perinatal outcomes. RESULT(S): After adjusting for confounders, compared with controls, subfertile women had increased odds of hypertension or preeclampsia (adjusted odds ratio [OR] 1.29, 1.02-1.61), antepartum hemorrhage (adjusted OR 1.41, 1.05-1.89), perinatal death (adjusted OR 2.19, 1.10-4.36), low birth weight (adjusted OR 1.44, 1.11-1.85), preterm birth <37 weeks (adjusted OR 1.32, 1.05-1.67) or <31 weeks (adjusted OR 2.37, 1.35-4.13), and cesarean delivery (adjusted OR 1.56, 1.37-1.77). There was weak evidence for increased birth defects (adjusted OR 1.30, 0.98-1.72) and gestational diabetes (adjusted OR 1.25, 0.96-1.63). No increased risk was found for prelabor rupture of membranes, small for gestational age, or postpartum hemorrhage. CONCLUSION(S): Subfertile women with singleton births are at increased risk of several adverse outcomes. These risks should be considered during their antenatal care and when analyzing adverse effects of ART.
OBJECTIVE: To determine whether adverse perinatal outcomes are increased in subfertile women. DESIGN: Cohort study. SETTING: Two tertiary assisted reproductive technologies (ART) centers; Victorian births register. PATIENT(S): Records of women who registered with the clinics (1991-2000), but did not have an infant using ART, were linked to the birth register (1991-2004) to identify singleton non-ART births within 5 years of registration (N = 2171). Controls, matched by maternal age and year of infant's birth, were selected randomly from birth records (N = 4363). INTERVENTIONS: None. MAIN OUTCOME MEASURE(S): Adverse obstetric and perinatal outcomes. RESULT(S): After adjusting for confounders, compared with controls, subfertile women had increased odds of hypertension or preeclampsia (adjusted odds ratio [OR] 1.29, 1.02-1.61), antepartum hemorrhage (adjusted OR 1.41, 1.05-1.89), perinatal death (adjusted OR 2.19, 1.10-4.36), low birth weight (adjusted OR 1.44, 1.11-1.85), preterm birth <37 weeks (adjusted OR 1.32, 1.05-1.67) or <31 weeks (adjusted OR 2.37, 1.35-4.13), and cesarean delivery (adjusted OR 1.56, 1.37-1.77). There was weak evidence for increased birth defects (adjusted OR 1.30, 0.98-1.72) and gestational diabetes (adjusted OR 1.25, 0.96-1.63). No increased risk was found for prelabor rupture of membranes, small for gestational age, or postpartum hemorrhage. CONCLUSION(S): Subfertile women with singleton births are at increased risk of several adverse outcomes. These risks should be considered during their antenatal care and when analyzing adverse effects of ART.
Authors: Michele Hansen; Elizabeth Milne; Nicholas de Klerk; Jennifer J Kurinczuk; Peter Jacoby; Carol Bower Journal: J Assist Reprod Genet Date: 2011-09-01 Impact factor: 3.412
Authors: Deirdre K Tobias; Jorge E Chavarro; Michelle A Williams; Germaine M Buck Louis; Frank B Hu; Janet Rich-Edwards; Stacey A Missmer; Cuilin Zhang Journal: Am J Epidemiol Date: 2013-08-15 Impact factor: 4.897
Authors: Lauren A Wise; Ellen M Mikkelsen; Henrik Toft Sørensen; Kenneth J Rothman; Kristen A Hahn; Anders H Riis; Elizabeth E Hatch Journal: Fertil Steril Date: 2015-02-20 Impact factor: 7.329