Adverse pregnancy and birth outcomes associated with underlying diagnosis with and without assisted reproductive technology treatment

被引:118
作者
Stern, Judy E. [1 ]
Luke, Barbara [2 ]
Tobias, Michael [3 ]
Gopal, Daksha [3 ]
Hornstein, Mark D. [4 ]
Diop, Hafsatou [5 ]
机构
[1] Geisel Sch Med Dartmouth, Dept Obstet & Gynecol, Lebanon, NS 03756, Lebanon
[2] Michigan State Univ, Dept Obstet Gynecol & Reprod Biol, E Lansing, MI 48824 USA
[3] Boston Univ, Sch Publ Hlth, Dept Community Hlth Sci, Boston, MA USA
[4] Harvard Univ, Brigham & Womens Hosp, Sch Med, Dept Obstet & Gynecol, Boston, MA 02115 USA
[5] Massachusetts Dept Publ Hlth, Boston, MA USA
关键词
ART; endometriosis; ovulatory disorder; pregnancy outcome; preterm delivery; low birth weight; PELVIC-INFLAMMATORY-DISEASE; WOMEN; INFERTILITY; DATABASE; MOSART;
D O I
10.1016/j.fertnstert.2015.02.027
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Objective: To compare the risks for adverse pregnancy and birth outcomes by diagnoses with and without assisted reproductive technology (ART) treatment to non-ART pregnancies in fertile women. Design: Historical cohort of Massachusetts vital records linked to ART clinic data from Society for Assisted Reproductive Technology Clinic Outcome Reporting System. Setting: Not applicable. Patient(s): Diagnoses included male factor (ART only), endometriosis, ovulation disorders, tubal (ART only), and reproductive inflammatory disorders (non-ART only). Pregnancies resulting in singleton and twin live births from 2004 to 2008 were linked to hospital discharges in women who had ART treatment (n = 3,689), women with no ART treatment in the current pregnancy (n = 4,098), and non-ART pregnancies in fertile women (n = 297,987). Intervention(s): None. Main Outcome Measure(s): Risks of gestational diabetes, prenatal hospitalizations, prematurity, low birth weight, and small for gestational age were modeled using multivariate logistic regression with fertile deliveries as the reference group adjusted for maternal age, race/ethnicity, education, chronic hypertension, diabetes mellitus, and plurality (adjusted odds ratios [AORs] and 95% confidence intervals [CIs]). Result(s): Risk of prenatal hospital admissions was increased for endometriosis (ART: 1.97, 1.38-2.80; non-ART: 3.34, 2.59-4.31), ovulation disorders (ART: 2.31, 1.81-2.96; non-ART: 2.56, 2.05-3.21), tubal factor (ART: 1.51, 1.14-2.01), and reproductive inflammation (non-ART: 2.79, 2.47-3.15). Gestational diabetes was increased for women with ovulation disorders (ART: 2.17, 1.72-2.73; non-ART: 1.94, 1.52-2.48). Preterm delivery (AORs, 1.24-1.93) and low birth weight (AORs, 1.27-1.60) were increased in all groups except in endometriosis with ART. Conclusion(s): The findings indicate substantial excess perinatal morbidities associated with underlying infertility-related diagnoses in both ART-treated and non-ART-treated women. (C) 2015 by American Society for Reproductive Medicine.
引用
收藏
页码:1438 / 1445
页数:8
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