Assisted fertilization and breech delivery: risks and obstetric management

被引:20
作者
Romundstad, Liv Bente [1 ,2 ]
Romundstad, Pal R. [2 ]
Sunde, Arne [1 ]
von During, Vidar [1 ]
Skjaerven, Rolv [3 ,4 ]
Vatten, Lars J. [2 ]
机构
[1] St Olavs Univ Hosp, IVF Unit, Dept Obstet & Gynaecol, NO-7006 Trondheim, Norway
[2] Norwegian Univ Sci & Technol, Dept Publ Hlth, N-7034 Trondheim, Norway
[3] Med Birth Registry Norway, Bergen, Norway
[4] Univ Bergen, Dept Publ Hlth & Primary Hlth Care, Bergen, Norway
关键词
assisted reproduction technology; breech presentation; singletons; Caesarean section; population study; POPULATION-BASED COHORT; IN-VITRO FERTILIZATION; FOLLOW-UP; PREGNANCIES; EMBRYO; BIRTH; INFERTILITY; SINGLETONS; OUTCOMES; WOMEN;
D O I
10.1093/humrep/dep301
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Previous studies have suggested that assisted reproduction technology (ART) is associated with increased risk of breech presentation. We investigated whether factors that tend to differ between ART and spontaneously conceived pregnancies may explain the higher risk of breech deliveries associated with ART. In this population-based cohort study, we included 1 209 151 singleton pregnancies reported to the Medical Birth Registry of Norway between 1984 and 2006 and compared the risk of breech presentation in 8229 ART pregnancies with that in spontaneously conceived pregnancies. Risk ratios (RR), adjusted for maternal age, parity, gestational length and year of birth, were estimated using binominal regression, and we describe differences and time trends in obstetric management for breech and cephalic presentations after ART compared with management of spontaneously conceived pregnancies. Breech presentation occurred nearly 50% more often in ART singleton pregnancies than in spontaneously conceived singletons [crude RR: 1.48, 95% confidence interval (CI): 1.34-1.64], but after adjustment for potentially confounding factors, the difference was fully attenuated (RR: 0.97, 95% CI: 0.88-1.07). The most important contributors to the attenuation were parity and length of gestation. In general, Caesarean sections and induced deliveries were more likely in ART pregnancies, but over the study period, the proportion of Caesarean sections in ART pregnancies gradually approached that of spontaneously conceived pregnancies. Increased risk of breech presentation in pregnancies after ART is mediated by lower parity and shorter gestational length. In general, the obstetric management of women with ART pregnancies is gradually approaching the ordinary surveillance of pregnant women.
引用
收藏
页码:3205 / 3210
页数:6
相关论文
共 24 条
[1]  
[Anonymous], COCHRANE DATABASE SY
[2]  
ANTOINE J-M, 1990, Journal de Gynecologie Obstetrique et biologie de la Reproduction, V19, P901
[3]   Uterine leiomyoma among women who conceived following fertility treatment [J].
Biderman-Madar T. ;
Sheiner E. ;
Levy A. ;
Potashnik G. ;
Mazor M. .
Archives of Gynecology and Obstetrics, 2005, 272 (3) :218-222
[4]   Long term outcome by method of delivery of fetuses in breech presentation at term: Population based follow up [J].
Danielian, PJ ;
Wang, J ;
Hall, MH .
BRITISH MEDICAL JOURNAL, 1996, 312 (7044) :1451-1453
[5]   AN OBSTETRIC ASSESSMENT OF THE 1ST 100 BIRTHS FROM THE INVITRO FERTILIZATION PROGRAM AT CLAMART, FRANCE [J].
FRYDMAN, R ;
BELAISCHALLART, J ;
FRIES, N ;
HAZOUT, A ;
GLISSANT, A ;
TESTART, J .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1986, 154 (03) :550-555
[6]   AN OBSTETRIC ANALYSIS OF 50 CONSECUTIVE PREGNANCIES AFTER TRANSFER OF CRYOPRESERVED HUMAN-EMBRYOS [J].
FRYDMAN, R ;
FORMAN, RG ;
BELAISCHALLART, J ;
HAZOUT, A ;
FERNANDEZ, H ;
TESTART, J .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1989, 160 (01) :209-213
[7]   Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomised multicentre trial [J].
Hannah, ME ;
Hannah, WJ ;
Hewson, SA ;
Hodnett, ED ;
Saigal, S ;
Willan, AR .
LANCET, 2000, 356 (9239) :1375-1383
[8]   FOLLOW-UP OF 30 PREGNANCIES AFTER EMBRYO CRYOPRESERVATION [J].
HEIJNSBROEK, I ;
HELMERHORST, FM ;
VANDENBERGHELDER, AF ;
VANDERZWAN, KJ ;
NAAKTGEBOREN, N ;
KEIRSE, MJNC .
EUROPEAN JOURNAL OF OBSTETRICS GYNECOLOGY AND REPRODUCTIVE BIOLOGY, 1995, 59 (02) :201-204
[9]   Perinatal outcome of singletons and twins after assisted conception: a systematic review of controlled studies [J].
Helmerhorst, FM ;
Perquin, DAM ;
Donker, D ;
Keirse, MJNC .
BRITISH MEDICAL JOURNAL, 2004, 328 (7434) :261-264B
[10]   Obstetric outcome among women with unexplained infertility after IVF: a matched case-control study [J].
Isaksson, R ;
Gissler, M ;
Tiitinen, A .
HUMAN REPRODUCTION, 2002, 17 (07) :1755-1761