Preterm delivery and low birth weight in singleton pregnancies conceived by women with and without a history of infertility

doi:10.1016/j.fertnstert.2012.04.033

Fertility and Sterility

Volume 98, Issue 3, September 2012, Pages 681-686.e1

https://doi.org/10.1016/j.fertnstert.2012.04.033 Get rights and content

Objective

To determine predictors of low birth weight (LBW) and preterm delivery (PTD) in singleton pregnancies conceived by women with and without a history of infertility.

Design

Retrospective cohort study.

Setting

Eleven infertility clinics in northern California.

Patient(s)

Three groups of women who carried singleton pregnancies to ≥20 weeks' gestation: 542 infertile women who conceived after treatment, 441 infertile women who conceived spontaneously, and 1,008 fertile women for comparison.

Intervention(s)

Chart review.

Main Outcome Measure(s)

Association of LBW or PTD with infertility treatment, maternal age, parity, obesity, or development of gestational diabetes.

Result(s)

Infertile women who conceived with treatment were more likely to be obese, develop gestational diabetes, and have ovarian, ovulatory, or male factor infertility than infertile women who conceived spontaneously. Infertile women who conceived after treatment had 1.61 times greater odds of having an LBW infant. Nulliparity was an independent predictor of LBW and PTD in all three groups after controlling for maternal age, history of infertility, infertility treatment, obesity, and gestational diabetes.

Conclusion(s)

Nulliparous women and women with a history of infertility who conceive a singleton after treatment may be at increased odds for having an LBW infant. Infertile women do not appear to be at increased odds for PTD.

Section snippets

Materials and methods

A cohort of 51,318 women who underwent evaluation or treatment for infertility between 1965 and 1998 at 14 infertility practices in California (11 in northern California and three in southern California) was assembled for the purpose of conducting health outcomes studies. Eligible women were evaluated for infertility or received treatment between January 1, 1965, and January 1, 1998, and did not have a personal history of cancer.

For this study, the cohort was limited to 30,448 women who

Results

Of the 983 women in the infertile cohort, 542 (55%) conceived with cycle-based infertility treatment, and 441 (45%) conceived spontaneously without infertility treatment (i.e., they had not undergone any infertility treatment within two menstrual cycles or 60 days before the estimated day of conception). Of the women who conceived after infertility treatment, 77% conceived using medications to induce or augment ovulation, 41% used intrauterine insemination (IUI), 12% conceived with IVF without

Discussion

One of the most significant clinical sequelae of infertility treatment is the high frequency of multiple births and associated poor perinatal outcomes, including PTD and LBW 10, 11. While some studies have described a similar increased risk in singleton pregnancies after ART 9, 12, 13, others have not 14, 15.

By comparing perinatal outcomes between infertile women who conceived with and without a variety of infertility treatments with a comparison group of fertile women, we were able to look at

Acknowledgments

The authors thank our scientific advisors: Denise Bernstein, L.V.N., Lauri Black, M.S., Marcelle Cedars, M.D., Nancy Chamberlain, Lisa Croen, Ph.D., Kari Danzinger, M.S., Seth Feigenbaum, M.D., Donna Ferriero, M.D., Judith Grether, Ph.D., Rebecca Jackson, M.D., Ph.D., H. Preston Nelson, M.D., Paul Turek, M.D., Yvonne Wu, M.D.; the assistants with data collection: Sujana Bhattacharyya, Allison Boissevain, Sharyn Boissevain, Zulma Flamenco, Christine Flanders-Koenig, Jennifer Fraser, Maria

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Obstetric outcomes in pregnancies resulting from in vitro fertilization are not different in fertile, sterilized women compared to infertile women: A Society for Assisted Reproductive Technology database analysis
2021, Fertility and Sterility
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Retrospective cohort study.
Not applicable.
Fresh, nondonor cycles excluding gestational surrogacy from 2004 to 2013 in the United States.
None.
Preterm birth rates and low birth weight rates from in vitro fertilization (IVF) pregnancies in couples with infertility and in couples with prior tubal ligation as their sole indication for IVF.
The mean ages of fertile women (N = 8,478) and infertile women (N = 371,488) were 35.3 and 34.6 years, respectively. Of the singletons born to parous women (N = 26,463), the incidence of preterm birth was not significantly different in fertile, sterilized couples compared to infertile couples (13.7% vs. 12.0%). The incidence of low birth weight among term singletons was also not significantly different between fertile couples compared to infertile couples (3.5% vs. 3.2%).
Fertile couples have similar preterm birth and low birth weight rates after IVF compared to infertile couples. This suggests that differences in perinatal outcomes may be due to assisted reproductive technology procedures rather than infertility itself.
Los resultados obstétricos en embarazos resultantes de fecundación in vitro no son diferentes en mujeres fértiles esterilizadas en comparación con mujeres infértiles: Análisis de una base de datos de la Sociedad para Tecnología de Reproducción Asistida.
Comparar resultados obstétricos y neonatales resultantes de tecnologías de reproducción asistida en parejas con historia de esterilización femenina con los de parejas con otros diagnósticos de infertilidad.
Estudio retrospectivo de cohorte.
No aplica
Ciclos en frescos de no donantes excluyendo la subrogación gestacional desde 2004 hasta 2013 en los Estados Unidos.
Ninguna.
La tasa de nacimientos pretérmino y la tasa de bajo peso al nacer de embarazos por fecundación in vitro (IVF) en parejas con infertilidad y en parejas con ligadura de trompas previa como su única indicación para IVF.
La media de edad para las mujeres fértiles (N=8,478) y mujeres infértiles (N=371,488) fue de 35.3 y 34.6 años, respectivamente. De los nacimientos únicos de las mujeres que tuvieron hijos (N=26,463), la incidencia de nacimientos pretérminos no fue significativamente diferente en parejas fértiles esterilizadas en comparación con parejas infértiles (13.7% vs. 12.0%). La incidencia de bajo peso al nacer entre nacimientos únicos a término tampoco fue significativamente diferente entre parejas fértiles en comparación con parejas infértiles (3.5% vs. 3.2%).
Las parejas fértiles tienen tasas similares de nacimientos pretérminos y bajo peso al nacer después de IVF en comparación con parejas infértiles. Esto sugiere que la diferencia en resultados perinatales puede que se deba a los procedimientos de las tecnologías de reproducción asistida en lugar de la infertilidad en sí.
Low birth weight: Is it related to assisted reproductive technology or underlying infertility?
2013, Fertility and Sterility
Since 1978, we have witnessed a successful evolution of assisted reproductive technology (ART), with improvement of the pregnancy rates and a growing demand. However, in recent years, there has been increasing concern regarding its safety due to the potential health impact on its infants. The raise of the developmental origins of adult disease has positioned low birth weight (LBW) as a significant health issue. Although multiple studies have associated ART with LBW, the etiology of this association remains largely unknown. We review the potential association between different components of ART and infertility with LBW, while acknowledging the limitations of interpretation of the existing literature.
Evidence-based reproductive risk epidemiology: The importance of multidisciplinary and multiprofessional methodologic collaboration
2012, Fertility and Sterility
Study profile matCH (Mothers and their children’s health) profile: Offspring of the 1973–78 cohort of the Australian longitudinal study on women’s health
2018, Longitudinal and Life Course Studies
Perinatal and Childhood Outcomes Associated with Infertility
2017, Seminars in Reproductive Medicine
History of infertility relates to increased risk of gestational diabetes mellitus: A meta-analysis
2017, International Journal of Clinical and Experimental Medicine

View all citing articles on Scopus

: L.C. received funding for travel to meetings from the European Society for Human Reproduction and Samuel Merritt University. A.A. has nothing to disclose. R.D.N. has nothing to disclose. M.S. has nothing to disclose. S.W. has nothing to disclose. M.S.C. has nothing to disclose.

: Supported by National Cancer Institute (NCI) grant 1-RO1-CA69619 and Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) grant 1-P01-HD-37074 (to M.S.C.).

View full text

Original articlePreterm delivery and low birth weight in singleton pregnancies conceived by women with and without a history of infertility

Objective

Design

Setting

Patient(s)

Intervention(s)

Main Outcome Measure(s)

Result(s)

Conclusion(s)

Section snippets

Materials and methods

Results

Discussion

Acknowledgments

Prenatal events and the risk of cerebral palsy in very low birth weight infants

Am J Epidemiol

Mental and motor development in preterm infants: the issue of corrected age

Early Hum Dev

Extreme prematurity and school outcomes

Paediatr Perinat Epidemiol

Behavioural problems in children who weigh 1000 g or less at birth in four countries

Lancet

Follow-up of very low birthweight babies to adolescence

Semin Neonatol

Learning disabilities and school problems in a regional cohort of extremely low birth weight (less than 1000 g) children: a comparison with term controls

J Dev Behav Pediatr

Cognitive abilities and school performance of extremely low birth weight children and matched term control children at age 8 years: a regional study

J Pediatr

Perinatal risks associated with assisted reproductive technology. ACOG Committee Opinion Number 324

Obstet Gynecol

Perinatal outcomes in singletons following in vitro fertilization: a meta-analysis

Obstet Gynecol

Factors influencing adverse perinatal outcomes in pregnancies achieved through use of in vitro fertilization

Fertil Steril

The impact of assisted reproduction on perinatal health care

Soz Praventivmed

Low and very low birth weight in infants conceived with use of assisted reproductive technology

N Engl J Med

Obstetric outcome of in vitro fertilization pregnancies compared with normally conceived pregnancies

Am J Obstet Gynecol

Is the obstetric outcome of in vitro fertilized singleton gestations different from natural ones? A controlled study

Fertil Steril

Singleton pregnancy after in vitro fertilization: expectations and outcome

Obstet Gynecol

The influence of donated gametes on the incidence of hypertensive disorders in pregnancy

Hum Reprod

Effect of parity and advanced maternal age on obstetric outcome

Int J Gynaecol Obstet

Original article
Preterm delivery and low birth weight in singleton pregnancies conceived by women with and without a history of infertility