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Fertil Steril. 2016 Oct;106(5):1142-1149.e14. doi: 10.1016/j.fertnstert.2016.06.021. Epub 2016 Jul 9.

Effect of maternal age on maternal and neonatal outcomes after assisted reproductive technology.

Author information

1
Department of Obstetrics and Gynecology, Institute for Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; Nordic IVF Center Göteborg, Gothenburg, Sweden. Electronic address: annalena.wennberg@gbgkk.se.
2
Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway; Central Norway Regional Health Authority, Stjørdal, Norway.
3
Department of Obstetrics and Gynecology, Institute for Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
4
Fertility Clinic, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
5
National Institute of Health and Welfare, Helsinki, Finland.
6
Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway; Central Norway Regional Health Authority, Stjørdal, Norway; Spiren Fertility Clinic, Trondheim, Norway.
7
Department of Obstetrics and Gynecology, Hvidovre Hospital, Institute of Clinical Medicine, Copenhagen University Hospital, Copenhagen, Denmark.
8
Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
9
Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; Medical Birth Registry of Norway, National Institute of Public Health, Bergen, Norway.

Abstract

OBJECTIVE:

To compare the effect of maternal age on assisted reproductive technology (ART) and spontaneous conception (SC) pregnancies regarding maternal and neonatal complications.

DESIGN:

Nordic retrospective population-based cohort study. Data from national ART registries were cross-linked with national medical birth registries.

SETTING:

Not applicable.

PATIENT(S):

A total of 300,085 singleton deliveries: 39,919 after ART and 260,166 after SC.

INTERVENTION(S):

None.

MAIN OUTCOME MEASURE(S):

Hypertensive disorders in pregnancy (HDP), placenta previa, cesarean delivery, preterm birth (PTB; <37 weeks), low birth weight (LBW; <2,500 g), small for gestational age (SGA), and perinatal mortality (≥28 weeks). Adjusted odds ratios (AORs) were calculated. Associations between maternal age and outcomes were analyzed.

RESULT(S):

The risk of placenta previa (AOR 4.11-6.05), cesarean delivery (AOR 1.18-1.50), PTB (AOR 1.23-2.19), and LBW (AOR 1.44-2.35) was significantly higher in ART than in SC pregnancies for most maternal ages. In both ART and SC pregnancies, the risk of HDP, placenta previa, cesarean delivery, PTB, LBW, and SGA changed significantly with age. The AORs for adverse neonatal outcomes at advanced maternal age (>35 years) showed a greater increase in SC than in ART. The change in risk with age did not differ between ART and SC for maternal outcomes at advanced maternal age.

CONCLUSION(S):

Having singleton conceptions after ART results in higher maternal and neonatal outcome risks overall, but the impact of age seems to be more pronounced in couples conceiving spontaneously.

KEYWORDS:

ART; Assisted reproductive technologies; maternal age; maternal complications; neonatal complications; spontaneous conception

[Indexed for MEDLINE]

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