Birth outcomes by infertility diagnosis: analyses of the massachusetts outcomes study of assisted reproductive technologies (MOSART)

Abstract

Objective To evaluate ART pregnancy outcomes by infertility diagnosis. Study Design ART data on women who were treated and gave birth in Massachusetts were linked to vital records and hospital utilization data. Live births were categorized by eight mutually-exclusive ART diagnoses. Risks of prematurity, low birthweight (LBW), small-for-gestation (SGA), large-for-gestation (LGA), pregnancy hypertension, gestational diabetes, prenatal hospitalizations, and primary cesarean delivery were modeled using logistic regression, adjusted for parental characteristics, treatment parameters, and plurality (adjusted odds ratios, AORs, and 95% confidence intervals); the reference group were pregnancies with the diagnosis of male factor. Results Among the 7,354 singleton and twin pregnancies, there were nonsignificant differences in the risks for LBW, SGA, or LGA. Significantly increased risks included gestational diabetes (ovulation disorders, AOR 1.80, 1.35–2.41); prematurity (ovulation disorders, AOR 1.36, 1.08–1.71; other factors, AOR 1.33, 1.05, 1.67); prenatal hospital admissions (endometriosis, tubal and other factors, ovulation disorders, and uterine factors, AORs ranging from 1.66 to 2.68); primary cesarean section (uterine factors, AOR 1.96, 1.15, 3.36). Conclusions Although the infant outcomes of LBW, SGA, and LGA were generally similar across diagnosis groups, specific diagnoses had greater risks for prematurity, gestational diabetes, prenatal hospital utilization, and primary cesarean delivery.

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

“…The subfertile population in that study, identified through a combination of birth certificate information, use of ART for previous deliveries, and hospitalizations that included ICD-9 codes of infertility (9), was not further categorized by specific infertility-related diagnosis. In another study we compared diagnosis categories within the ART population using male factor pregnancies as the reference group and found elevated risks for gestational diabetes and preterm delivery in women with ovulation disorders as well as an increased risk of prenatal hospital admissions for women with endometriosis (5). Diagnoses have also been shown to affect outcome in other studies (12, 13).…”

Perinatal outcomes of singleton siblings: the effects of changing maternal fertility status

“…This analysis is part of a larger population-based study of ART in Massachusetts [14][15][16][17][18][19][20][21][22][23][24][25][26][27]. The objective of this current analysis is to evaluate the effect of maternal fertility status (fertile, subfertile, or ART) on the pregnancy and birth outcomes in consecutive singleton births.…”

130: Adverse pregnancy outcomes after in vitro fertilization: effect of number of embryos transferred and plurality at conception

“…This is the third in a series of analyses evaluating the effect of ART diagnoses and treatment parameters on the course and outcome of pregnancy (13,14). This within-ART set of analyses is part of a larger population-based study of ART in Massachusetts (13)(14)(15)(16)(17)(18)(19)(20)(21).…”

“…This within-ART set of analyses is part of a larger population-based study of ART in Massachusetts (13)(14)(15)(16)(17)(18)(19)(20)(21). The objective of this current analysis is to evaluate the effect of number of embryos transferred (ET) and plurality at the six-week ultrasound (fetal heartbeats, FHB) on the pregnancy and birth outcomes of singleton births, specifically prematurity, low birthweight, and small-forgestational age birthweight.…”