Comparison of neonatal outcomes of very low birth weight infants by mode of conception: in vitro fertilization versus natural pregnancy

Objective: To compare the neonatal outcomes of very low birth weight (VLBW) infants born after IVF with those of VLBW infants born after natural pregnancy (NP). Design: Prospective cohort study. Setting: Not applicable. Patient(s): A total of 6,871 VLBW infants born from January 2014 to December 2016. Intervention(s): None. Main Outcome Measure(s): Neonatal mortality and morbidities. Result(s): Of the 6,871 VLBW infants enrolled, 4,438 infants were born as singletons (IVF = 271; NP = 4,167), and 2,433 infants were born as multiplets (IVF = 1,301; NP = 1,132). After adjustment for maternal and neonatal baseline characteristics, infants born as singletons earlier than 28 weeks after IVF more frequently had high-stage retinopathy of prematurity than those born after NP, whereas infants born as multiplets between 28 and 31 weeks after IVF had fewer major congenital anomalies, high-grade intraventricular hemorrhage, and periventricular leukomalacia than those born after NP. Otherwise, no differences in mortality and neonatal outcomes were found. Conclusion(s): Very low birth weight infants born as singletons after IVF had comparable neonatal outcomes to those born after NP, except for an increased risk of high-stage retinopathy of prematurity. Very low birth weight infants born as multiplets after IVF had fewer neurologic morbidities than those born after NP. ((C) 2019 by American Society for Reproductive Medicine.)