Outcomes of Very Preterm Infants Conceived with Assisted Reproductive Technologies

The effect of fertility treatment and socioeconomic status on neonatal and post-neonatal mortality in the United States

“…Previously, our group demonstrated a two-fold increase in mortality following ART among infants diagnosed with pulmonary vascular disease in a US population-based study, but these differences became insignificant after controlling for gestational age [ 31 ]. In a separate single center study, we found a non-significant elevation in 1-year mortality for ART versus spontaneously conceived very preterm infants (<32 weeks) [ 32 ].…”

Fertility treatment increases the risk of preterm birth independent of multiple gestations

“…Whether neonatal morbidity after fertility treatment is affected beyond the relationship to prematurity is less well-established. Our prior studies suggest that prematurity is a major driver of some of the reported fertility treatment-induced adverse outcomes ( 26 , 27 ). For example, we found that infant outcomes (mortality and need for respiratory support) were not different between those conceived spontaneously vs. ART in a very preterm (<32 weeks’ GA) cohort matched for GA and multiple gestation ( 27 ).…”

“…Our prior studies suggest that prematurity is a major driver of some of the reported fertility treatment-induced adverse outcomes ( 26 , 27 ). For example, we found that infant outcomes (mortality and need for respiratory support) were not different between those conceived spontaneously vs. ART in a very preterm (<32 weeks’ GA) cohort matched for GA and multiple gestation ( 27 ). Thus, understanding the driver of preterm birth in this population is of paramount importance to mitigate adverse outcomes and optimize child health.…”

Reply

“…Within this framework, we found no differences in one-year mortality or respiratory outcomes. Despite matching on these two important confounders, there are inherent limitations to a single-center, retrospective investigation, with a relatively small sample size (54 ART cases matched with 103 spontaneous cases) 1 .…”