Risk of severe maternal morbidity by maternal fertility status: a US study in 8 states

Abstract

BACKGROUND: Over the past 2 decades the characteristics of women giving birth in the United States and the nature of the births themselves have changed dramatically, with increases in older maternal age, plural births, cesarean deliveries, and conception from infertility treatment. OBJECTIVE: We sought to evaluate the risk of severe maternal morbidity by maternal fertility status, and for in vitro fertilization pregnancies, by oocyte source and embryo state combinations. STUDY DESIGN: Women in 8 states who underwent in vitro fertilization cycles resulting in a live birth during 2004 through 2013 were linked to their infant's birth certificates; a 10:1 sample of births from non-in vitro fertilization deliveries were selected for comparison; those with an indication of infertility treatment on the birth certificate were categorized as subfertile, all others were categorized as fertile. In vitro fertilization pregnancies were additionally categorized by oocyte source (autologous vs donor) and embryo state (fresh vs thawed). Maternal morbidity was identified from the birth certificate, modeled using logistic regression, and reported as adjusted odds ratios [95% confidence intervals]. The reference group was fertile women.

In vitro fertilization and risk for hypertensive disorders of pregnancy: associations with treatment parameters

“…Our findings add to a growing literature regarding adverse outcomes associated with specific subfertility and with particular types of IVF treatment [12-29, 32, 34-36], including perinatal and maternal morbidity. For example, a recent analysis of the risk of severe maternal morbidity by our group reported a two-fold greater risk of unplanned hysterectomy among autologous-thawed and donor-thawed IVF pregnancies [36]. Our findings demonstrating an increased risk of hypertensive disorders with ooycte donation are similar to Blazquez et al who also noted a similar risk of preeclampsia for fresh compared with frozen embryo transfers using donor oocytes [37].…”

Is Embryo Cryopreservation Causing Macrosomia—and What Else?

“…Compared to fertile women, subfertile, and IVF-treated women had increased risks for blood transfusion and thirdor fourth-degree perineal laceration. Also, compared to fertile women, the risk of unplanned hysterectomy and ruptured uterus was increased for IVF-treated women (11).…”

Defining critical factors in multi-country studies of assisted reproductive technologies (ART): data from the US and UK health systems

“…Of the 97.6% individuals reporting being of one race in the 2010 census, 72.4% were White, 12.6% were Black or African American, 4.8% were Asian, 6.2% were other races, 0.9% were American Indian or Alaskan Native, and 0.2% were Native Hawaiian and Other Pacific Islander. In most of our prior infertility analyses, we have categorized race as White, Black or African American, Asian, and Other (or mixed), and categorized Hispanic ethnicity as yes/no [63][64][65][70][71][72]. We identified significant diversity in our studies, with the number of non-white participants ranging from 8.6 to 34.5% of the study populations, and Hispanic participants ranging from 1.0 to 26.5% of the study populations.…”