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J Assist Reprod Genet. 2019 Jan;36(1):121-138. doi: 10.1007/s10815-018-1333-z. Epub 2018 Oct 17.

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

Author information

1
Department of Obstetrics, Gynecology, and Reproductive Biology, College of Human Medicine, Michigan State University, 965 Fee Road, East Fee Hall, Room 628, East Lansing, MI, USA. lukeb@msu.edu.
2
Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
3
Redshift Technologies, Inc., New York, NY, USA.
4
Yale Fertility, Yale School of Medicine, New Haven, CT, USA.
5
Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA, USA.
6
Seattle Reproductive Medicine, Seattle, WA, USA.
7
Center for Assisted Reproduction, Bedford, TX, USA.
8
Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA.

Abstract

PURPOSE:

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.

METHODS:

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).

RESULTS:

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.

CONCLUSIONS:

Prematurity was associated with placental complications, diabetes and hypertension, subfertility and IVF groups, and in IVF pregnancies, donor oocytes and/or thawed embryos.

KEYWORDS:

Embryo state; Fertility status; Infant morbidity; Infant mortality; Oocyte source; Placental complications; Prematurity

PMID:
30328574
PMCID:
PMC6338589
[Available on 2020-01-01]
DOI:
10.1007/s10815-018-1333-z
[Indexed for MEDLINE]

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