OBJECTIVE: To determine if fertility treatment is associated with increased risk of severe maternal morbidity (SMM) compared with spontaneous pregnancies. DESIGN: Retrospective cohort study. SETTING: Academic medical center. PATIENT(S): In 2012, 6,543 women delivered live births >20 weeks gestation at our center. Women were categorized based on mode of conception: in vitro fertilization (IVF), non-IVF fertility treatment (NIFT), or spontaneous pregnancies. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): The main outcome was presence of true SMM, such as eclampsia, respiratory failure, and peripartum hysterectomy. Deliveries were screened with the use of: 1) International Classification of Diseases 9 codes; 2) prolonged postpartum stay; 3) maternal intensive care unit admissions, and 4) blood transfusion. The charts of women meeting the screening criteria were reviewed to identify true SMM based on a previously validated method, recognizing that medical record review is the criterion standard. RESULT(S): Of the 6,543 deliveries, 246 (3.8%) were IVF conceptions and 109 (1.7%) NIFT conceptions. Sixty-nine cases of true SMM were identified (1.1%). In multivariate analyses, any fertility treatment (IVF + NIFT) was associated with increased risk of SMM compared with spontaneous conceptions. In a subset analysis of singletons only, the association between any fertility treatment (IVF + NIFT) and SMM was not statistically significant. CONCLUSION(S): Overall, fertility treatment increased risk for SMM events. Given the limited sample size, the negative finding with singleton gestations is inconclusive. Larger multicenter studies with accurate documentation of fertility treatment and SMM cases are needed to further clarify the risk associated with singletons.
OBJECTIVE: To determine if fertility treatment is associated with increased risk of severe maternal morbidity (SMM) compared with spontaneous pregnancies. DESIGN: Retrospective cohort study. SETTING: Academic medical center. PATIENT(S): In 2012, 6,543 women delivered live births >20 weeks gestation at our center. Women were categorized based on mode of conception: in vitro fertilization (IVF), non-IVF fertility treatment (NIFT), or spontaneous pregnancies. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): The main outcome was presence of true SMM, such as eclampsia, respiratory failure, and peripartum hysterectomy. Deliveries were screened with the use of: 1) International Classification of Diseases 9 codes; 2) prolonged postpartum stay; 3) maternal intensive care unit admissions, and 4) blood transfusion. The charts of women meeting the screening criteria were reviewed to identify true SMM based on a previously validated method, recognizing that medical record review is the criterion standard. RESULT(S): Of the 6,543 deliveries, 246 (3.8%) were IVF conceptions and 109 (1.7%) NIFT conceptions. Sixty-nine cases of true SMM were identified (1.1%). In multivariate analyses, any fertility treatment (IVF + NIFT) was associated with increased risk of SMM compared with spontaneous conceptions. In a subset analysis of singletons only, the association between any fertility treatment (IVF + NIFT) and SMM was not statistically significant. CONCLUSION(S): Overall, fertility treatment increased risk for SMM events. Given the limited sample size, the negative finding with singleton gestations is inconclusive. Larger multicenter studies with accurate documentation of fertility treatment and SMM cases are needed to further clarify the risk associated with singletons.
Authors: Elliott K Main; Anisha Abreo; Jennifer McNulty; William Gilbert; Colleen McNally; Debra Poeltler; Katarina Lanner-Cusin; Douglas Fenton; Theresa Gipps; Kathryn Melsop; Naomi Greene; Jeffrey B Gould; Sarah Kilpatrick Journal: Am J Obstet Gynecol Date: 2015-11-12 Impact factor: 8.661
Authors: Beverley Lawton; Evelyn Jane MacDonald; Selina Ann Brown; Leona Wilson; James Stanley; John David Tait; Richard Alan Dinsdale; Carolyn Lee Coles; Stacie E Geller Journal: Am J Obstet Gynecol Date: 2014-02-06 Impact factor: 8.661
Authors: Richard J Paulson; Robert Boostanfar; Peyman Saadat; Eliran Mor; David E Tourgeman; Cristin C Slater; Mary M Francis; John K Jain Journal: JAMA Date: 2002-11-13 Impact factor: 56.272
Authors: Kristen E Gray; Erin R Wallace; Kailey R Nelson; Susan D Reed; Melissa A Schiff Journal: Paediatr Perinat Epidemiol Date: 2012-11 Impact factor: 3.980
Authors: Margareta D Pisarska; Jessica L Chan; Kate Lawrenson; Tania L Gonzalez; Erica T Wang Journal: J Clin Endocrinol Metab Date: 2019-06-01 Impact factor: 5.958
Authors: Natalie Dayan; K S Joseph; Deshayne B Fell; Carl A Laskin; Olga Basso; Alison L Park; Jin Luo; Jun Guan; Joel G Ray Journal: CMAJ Date: 2019-02-04 Impact factor: 8.262
Authors: Lisa M Korst; Kimberly D Gregory; Lisa A Nicholas; Samia Saeb; David J Reynen; Jennifer L Troyan; Naomi Greene; Moshe Fridman Journal: Matern Health Neonatol Perinatol Date: 2021-01-06