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Risk of prematurity and infant morbidity and mortality by maternal fertility status and plurality
Journal article   Open access   Peer reviewed

Risk of prematurity and infant morbidity and mortality by maternal fertility status and plurality

Barbara Luke, Morton B Brown, Ethan Wantman, David B Seifer, Amy T Sparks, Paul C Lin, Kevin J Doody, Bradley J Van Voorhis and Logan G Spector
Journal of assisted reproduction and genetics, Vol.36(1), pp.121-138
01/2019
DOI: 10.1007/s10815-018-1333-z
PMCID: PMC6338589
PMID: 30328574
url
https://europepmc.org/articles/pmc6338589View
Published (Version of record) Open Access

Abstract

To evaluate the risk of prematurity and infant mortality by maternal fertility status, and for in vitro fertilization (IVF) pregnancies, by oocyte source and embryo state combinations. Women in 14 States who had IVF-conceived live births during 2004-13 were linked to their infant's birth and death certificates; a 10:1 sample of non-IVF births was selected for comparison; those with an indication of infertility treatment on the birth certificate were categorized as subfertile, all others were categorized as fertile. Risks were modeled separately for the fertile/subfertile/IVF (autologous-fresh only) group and for the IVF group by oocyte source-embryo state combinations, using logistic regression, and reported as adjusted odds ratios (AORs) and 95% confidence intervals (CI). The study population included 2,474,195 pregnancies. Placental complications (placenta previa, abruptio placenta, and other excessive bleeding) and prematurity were both increased with pregestational and gestational diabetes and hypertension, among subfertile and IVF groups, and in IVF pregnancies using donor oocytes. Both subfertile and IVF pregnancies were at risk for prematurity and NICU admission; IVF infants were also at risk for small-for-gestation birthweight, and subfertile infants had greater risks for neonatal and infant death. Within the IVF group, pregnancies with donor oocytes and/or thawed embryos were at greater risk of large-for-gestation birthweight, and pregnancies with thawed embryos were at greater risk of neonatal and infant death. Prematurity was associated with placental complications, diabetes and hypertension, subfertility and IVF groups, and in IVF pregnancies, donor oocytes and/or thawed embryos.
Fertilization in Vitro - adverse effects United States - epidemiology Infant, Newborn, Diseases - epidemiology Pregnancy, Multiple Placenta Diseases - epidemiology Humans Risk Factors Infant, Newborn, Diseases - mortality Infertility - complications Placenta Diseases - mortality Premature Birth - epidemiology Pregnancy Young Adult Maternal Age Fertility Adolescent Adult Female Infant, Newborn

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