Journal article
Trends in Severe Maternal Morbidity After Assisted Reproductive Technology in the United States, 2008-2012
Obstetrics and gynecology (New York. 1953), Vol.127(1), pp.59-66
01/01/2016
DOI: 10.1097/AOG.0000000000001197
PMCID: PMC11099826
PMID: 26646124
Abstract
OBJECTIVETo examine trends in severe maternal morbidity from 2008 to 2012 in delivery and postpartum hospitalizations among pregnancies conceived with or without assisted reproductive technology (ART). METHODSIn this retrospective cohort study, deliveries were identified in the 2008-2012 Truven Health MarketScan Commercial Claims and Encounters Databases. Severe maternal morbidity was identified using International Classification of Diseases, 9th Revision, Clinical Modification diagnosis codes and Current Procedural Terminology codes. Rate of severe maternal morbidity was calculated for ART and non-ART pregnancies. We performed multivariable logistic regression, controlling for maternal characteristics, and calculated adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for severe morbidity. Additionally, a propensity score analysis was performed between ART and non-ART deliveries. RESULTSOf 1,016,618 deliveries, 14,761 (1.5%) were identified as pregnancies conceived with ART. Blood transfusion was the most common severe morbidity indicator for ART and non-ART pregnancies. For every 10,000 singleton deliveries, there were 273 ART deliveries or postpartum hospitalizations with severe maternal morbidity compared with 126 for non-ART (P<.001). For ART singleton deliveries, the rate of severe morbidity decreased from 369 per 10,000 deliveries in 2008 to 219 per 10,000 deliveries in 2012 (P=.025). Odds of severe morbidity were increased for ART compared with non-ART singletons (adjusted OR 1.84, 95% CI 1.63-2.08). Among multiple gestations, there was no significant difference between ART and non-ART pregnancies (rate of severe morbidity for ART 604/10,000 and non-ART 539/10,000 deliveries, P=.089; adjusted OR 1.04, 95% CI 0.91-1.20). Propensity score matching agreed with these results. CONCLUSIONSingleton pregnancies conceived with ART are at increased risk for severe maternal morbidity; however, the rate has been decreasing since 2008. Multiple gestations have increased risk regardless of ART status.
Details
- Title: Subtitle
- Trends in Severe Maternal Morbidity After Assisted Reproductive Technology in the United States, 2008-2012
- Creators
- Angela S Martin - Center for Surveillance, Epidemiology, and Laboratory ServicesMichael Monsour - National Center for Chronic Disease Prevention and Health PromotionDmitry M Kissin - Centers for Disease Control and PreventionDenise J Jamieson - Center for Surveillance, Epidemiology, and Laboratory ServicesWilliam M Callaghan - Centers for Disease Control and PreventionSheree L Boulet - National Center for Chronic Disease Prevention and Health Promotion
- Resource Type
- Journal article
- Publication Details
- Obstetrics and gynecology (New York. 1953), Vol.127(1), pp.59-66
- DOI
- 10.1097/AOG.0000000000001197
- PMID
- 26646124
- PMCID
- PMC11099826
- NLM abbreviation
- Obstet Gynecol
- ISSN
- 0029-7844
- eISSN
- 1873-233X
- Language
- English
- Date published
- 01/01/2016
- Academic Unit
- Obstetrics and Gynecology; VPMA - Administration
- Record Identifier
- 9984446525402771
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