Maternal and neonatal health outcomes following assisted reproduction

Farhi, Adel; Reichman, Brian; Boyko, Valentina; Hourvitz, Ariel; Ron-El, Raphaël; Lerner‐Geva, Liat

doi:10.1016/j.rbmo.2013.01.014

Cited by 61 publications

(62 citation statements)

References 29 publications

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“…The greater risk in IVF-treated women may reflect more severe infertility, more extensive underlying pathology, or other unfavorable factors not measured in this study. The frequency and magnitude of the risks of adverse outcomes we found in the IVF group are in accord with prior results from clinical studies (1, 6, 7, 10, 12, 21, 46, 47) and meta-analyses (2, 3, 5, 8). These findings also extend the results from the original analysis (30) which limited adverse outcomes to preterm birth, low birthweight, small-for-gestational age, and perinatal death, demonstrating that compared to fertile women, women with subfertility or treated with IVF are at significantly greater risk for gestational diabetes, pregnancy hypertension, uterine bleeding, placental complications, prenatal hospitalizations, primary cesarean delivery, and their infants are at greater risk for very low birthweight, very preterm birth, birth defects, and neonatal death.…”

Section: Discussionsupporting

confidence: 90%

“…Studies have confirmed a higher frequency of abnormal placentation in pregnancies conceived through both ovulation induction (46) and IVF (46–48). Compared to women without infertility treatment, Shevell et al (48) reported increased risks of placental abruption with ovulation induction (AOR 2.4, 95% CI 1.3, 4.2) and IVF (AOR 2.4, 95% CI 1.1, 5.2), and placenta previa with IVF (AOR 6.0, 95% CI 3.4, 10.7).…”

Section: Discussionmentioning

confidence: 95%

See 1 more Smart Citation

Pregnancy, birth, and infant outcomes by maternal fertility status: the Massachusetts Outcomes Study of Assisted Reproductive Technology

Luke

Gopal

Cabral

et al. 2017

American Journal of Obstetrics and Gynecology

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Background Births to subfertile women, with and without infertility treatment, have been reported to have lower birthweights and shorter gestations, even when limited to singletons. It is unknown whether these decrements are due to parental characteristics or aspects of infertility treatment. Objective To evaluate the effect of maternal fertility status on the risk of pregnancy, birth, and infant complications. Study Design All singleton live births of ≥22 weeks’ gestation and ≥350 grams birthweight to Massachusetts resident women in 2004–10 were linked to hospital discharge and vital records. Women were categorized by their fertility status as in vitro fertilization (IVF), subfertile, or fertile. Women whose births linked to IVF cycles from the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System were classified as IVF. Women with indicators of subfertility but not treated with IVF were classified as subfertile. Women without indicators of subfertility or IVF treatment were classified as fertile. Risks of fifteen adverse outcomes (gestational diabetes, pregnancy hypertension, antenatal bleeding, placental complications (placenta abruptio and placenta previa), prenatal hospitalizations, primary cesarean, very low birthweight (<1,500g), low birthweight (<2,500g), small-for-gestation birthweight (Z-score ≤−1.28), large-for-gestation birthweight (Z-score ≥1.28), very preterm (<32 weeks), preterm (<37 weeks), birth defects, neonatal death (0–27 days), and infant death (0–364 days of life) were modeled by fertility status with the fertile group as reference, and the subfertile group as reference, using multivariate log binomial regression and reported as adjusted risk ratios (ARRs) and 95% confidence intervals. Results The study population included 459,623 women (441,420 fertile, 8,054 subfertile, and 10,149 IVF). Women in the subfertile and IVF groups were older than their fertile counterparts. Risks for six out of six pregnancy outcomes and six out of nine infant outcomes were increased for the subfertile group, and five out of six pregnancy outcomes and seven out of nine infant outcomes were increased for the IVF group. For four of the six pregnancy outcomes (uterine bleeding, placental complications, prenatal hospitalizations, and primary cesarean) and two of the infant outcomes (low birthweight and preterm) the risk was greater in the IVF group, with non-overlapping confidence intervals to the subfertile group, indicating a substantially higher risk among IVF-treated women. The highest risks for the IVF women were uterine bleeding (ARR 3.80, 95% CI 3.31, 4.36) and placental complications (ARR 2.81, 95% CI 2.57, 3.08), and for IVF infants, very preterm birth (ARR 2.13, 95% CI 1.80, 2.52) and very low birthweight (ARR 2.15, 95% CI 1.80, 2.56). With subfertile women as reference, risks for the IVF group were significantly increased for uterine bleeding, placental complications, prenatal hospitalizations, primary cesarean, low and very low birthweight, and preterm and very preterm bir...

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 95%

Pregnancy, birth, and infant outcomes by maternal fertility status: the Massachusetts Outcomes Study of Assisted Reproductive Technology

Luke

Gopal

Cabral

et al. 2017

American Journal of Obstetrics and Gynecology

View full text Add to dashboard Cite

show abstract

“…40 [10,[31][32][33], suggesting that this complication may be related to the technique of embryo transfer, with implantation occurring lower in the uterus with IVF. This may not completely explain the etiology of placental complications, as we found a twofold increased risk in first births among subfertile women (AOR 1.97, 95 % CI 1.33-2.93), who conceived without ART.…”

Section: Discussionmentioning

confidence: 99%

Perinatal outcomes of singleton siblings: the effects of changing maternal fertility status

Luke

Gopal

Cabral

et al. 2016

J Assist Reprod Genet

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“…1 Among children born following these treatments, increased risk of adverse birth outcomes has been observed, including multiple births, preterm births, and congenital malformations. [2][3][4][5] The possibility of an increased risk for cancer among children born following ART has been suggested, however most studies published thus far have included small sample sizes and short follow-up periods. Two meta-analyses have been conducted summarizing the results of these studies.…”

Section: Introductionmentioning

confidence: 99%

Possible risk for cancer among children born following assisted reproductive technology in Israel

Lerner‐Geva

Boyko

Ehrlich

et al. 2016

Pediatr Blood Cancer

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Maternal and neonatal health outcomes following assisted reproduction

Cited by 61 publications

References 29 publications

Pregnancy, birth, and infant outcomes by maternal fertility status: the Massachusetts Outcomes Study of Assisted Reproductive Technology

Pregnancy, birth, and infant outcomes by maternal fertility status: the Massachusetts Outcomes Study of Assisted Reproductive Technology

Perinatal outcomes of singleton siblings: the effects of changing maternal fertility status

Possible risk for cancer among children born following assisted reproductive technology in Israel

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