Risk of spontaneous preterm birth in singleton pregnancies conceived after IVF/ICSI treatment: meta‐analysis of cohort studies

Cavoretto, Paolo; Candiani, Massimo; Giorgione, Veronica; Inversetti, Annalisa; Abu‐Saba, Matilda Marta; Tiberio, F.; Sigismondi, Cristina; Farina, Antonio

doi:10.1002/uog.18930

Cited by 167 publications

(131 citation statements)

References 45 publications

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“…The population‐based nature of the dataset that we used gave us the opportunity to examine baseline characteristics between infants with PVD born with and without the use of ART/NIFT. Similar to other epidemiological studies investigating ART, we found that preterm birth is much more common in infants exposed to ART/NIFT than with infants without exposure to maternal IT. While preterm birth is a common occurrence in multiple gestations associated with ART/NIFT, it is also two‐fold more frequent in singleton gestation generated by ART .…”

Section: Discussionsupporting

confidence: 90%

Outcomes of pulmonary vascular disease in infants conceived with non‐IVF fertility treatment and assisted reproductive technologies at 1 year of age

Fineman

Baer

Chambers

et al. 2019

Pediatric Pulmonology

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Background Assisted reproductive technologies (ARTs) have been associated with the development of endothelial dysfunction. Objective To determine potential differences in outcomes associated with pulmonary vascular disease in infants born to mothers receiving any infertility treatment including ART and non‐IVF fertility treatments (NIFTs). Design/Methods The sample was derived from an administrative database containing detailed information on infant and maternal characteristics for live‐born infants in California (2007‐2012) with gestational age (GA) 22 to 44 weeks. Cases were defined as infants with ICD‐9 code for pulmonary vascular disease (PVD) and records for ART/NIFT. Controls were randomly selected at a 1:4 ratio. The primary outcome was 1‐year mortality. Crude and adjusted odds ratio (OR) with 95% confidence interval (CI) were calculated. Results We identified 159 cases and 636 controls. Mothers that utilized ART/NIFT were older, to be of the Caucasian race, to have pre‐eclampsia, private insurance, and education >12 years (P < .001). Cases compared to controls were more premature, had lower birth weights, and were more often the product of a multiple gestation pregnancy (P < .001). Cases had a higher 1‐year mortality (18.2% vs 9.1%; OR: 2.2; 95% CI: 1.4, 3.6), more severe PVD (86.2% vs 72.3%; OR: 2.4; 95% CI: 1.5, 3.9), and a longer hospital stay (66.7 ± 73.0 vs 32.5 ± 47.2 days; P < .001) than controls. However, when adjusting for GA these differences become statistically insignificant. Conclusion Children born following ART/NIFT with PVD had increased mortality compared to infants with PVD but without ART/NIFT. The primary driver of this relationship is prematurity.

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Section: Discussionsupporting

confidence: 90%

Outcomes of pulmonary vascular disease in infants conceived with non‐IVF fertility treatment and assisted reproductive technologies at 1 year of age

Fineman

Baer

Chambers

et al. 2019

Pediatric Pulmonology

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“…Conversely, several studies in the literature have shown that IVF/ICSI pregnancies themselves carry risks for obstetric complications and adverse perinatal outcomes compared with spontaneous pregnancies, even in singleton gestations . The risk of spontaneous preterm birth in singleton pregnancies resulting from IVF/ICSI is significantly greater than that in spontaneously conceived singletons according to a recently performed meta‐analysis of the cohort studies . In our study, monochorionic pregnancies and spontaneously conceived pregnancies were excluded and only ICSI singleton births were included in both the study and control groups, thus resulting in a homogeneous population.…”

Section: Discussionmentioning

confidence: 93%

“…3,4,8,9 The risk of spontaneous preterm birth in singleton pregnancies resulting from IVF/ICSI is significantly greater than that in spontaneously conceived singletons according to a recently performed meta-analysis of the cohort studies. 10 In our study, monochorionic pregnancies and spontaneously conceived pregnancies were excluded and only ICSI singleton births were included in both the study and control groups, thus resulting in a homogeneous population. Our study is also unique in that both infertility treatment and pregnancy followup of the study and control groups were in a single center, Bas¸kent University Ankara Hospital.…”

Section: Discussionmentioning

confidence: 99%

Outcome of ICSI pregnancies with spontaneous loss of a co‐twin compared with singleton ICSI pregnancies: Single center experience

Uysal

Gülümser

Yanık

et al. 2020

J of Obstet and Gynaecol

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Aim To compare the outcome of intracytoplasmic sperm injection (ICSI) pregnancies complicated by spontaneous loss of a dichorionic co‐twin with that of singleton ICSI pregnancies. Methods The study group included dichorionic ICSI pregnancies with co‐twin loss (n = 33) and the control group included ICSI pregnancies with a singleton from the beginning (n = 327). Primary outcome measures were obstetric complications, including preterm delivery, newborn small for gestational age, gestational diabetes, gestational hypertensive disorders and abruptio placenta; admission to neonatal intensive care unit (NICU) and perinatal mortality observed in the study and control groups. Statistical analysis was performed using spss for Windows, version 22.0. Results In the study group, there were 26 cases of first trimester (early) and 7 cases of second or third trimester (late) co‐twin losses. Mean gestational age at delivery and mean birth weight were significantly lower in the whole study group compared to control (P < 0.05). Preterm delivery and NICU admission rates were significantly higher in the whole study group, compared to control (39.3% vs 14.6% and 36.36% vs 11.69% respectively, P < 0.05), but did not show significant difference between early loss subgroup and control (P > 0.05). Preterm delivery rate was significantly higher in the late loss subgroup compared to the early loss subgroup (85.71% vs 26.92% P < 0.05). Conclusion Loss of a co‐twin in dichorionic ICSI pregnancies is associated with increased risk of preterm birth. This risk is significantly higher in cases with late loss compared to the early loss cases.

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“…To date, most studies have evaluated the potential benefit of pre-conception or early administration of low-dose aspirin in women with a history of recurrent pregnancy loss, (37)(38)(39)(40) women who have undergone in vitro fertilization (IVF) (28,(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54) or women with thrombophilia or antiphospholipid syndrome. (55)(56)(57)(58)(59)(60)(61)(62)(63)(64)(65) It is recognized that these women are at an increased risk of placenta-associated complications of pregnancy, including hypertensive disorder of pregnancy, (66)(67)(68)(69) preterm delivery, (70,71) and fetal growth restriction. (70,72) The objective of this study was to perform a systematic review and meta-analysis to estimate the effect of low-dose aspirin initiated at <11 weeks' gestation on the risk of preeclampsia, gestational hypertension, or any hypertensive disorder of pregnancy.…”

Section: Introductionmentioning

confidence: 99%

Does low-dose aspirin initiated before 11 weeks’ gestation reduce the rate of preeclampsia?

Chaemsaithong

Cuenca-Gomez

Plana

et al. 2020

American Journal of Obstetrics and Gynecology

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Condensation: Aspirin given at <11 weeks' gestation in high risk women does not reduce the risk of preeclampsia and gestational hypertension but may reduce the risk of preterm delivery. Short title: Early aspirin administration and preeclampsia PROSPERO registration number: CRD42019125006 AJOG at a Glance: Why was this study conducted? • To perform a systematic review and meta-analysis to evaluate the effect of lowdose aspirin initiated at <11 weeks' gestation on the risk of preeclampsia, gestational hypertension, or any hypertensive disorder of pregnancy. Secondary outcomes included preterm delivery at <37 weeks' gestation and fetal growth restriction. Key findings • The administration of low-dose aspirin at <11 weeks' gestation in women with a history of recurrent pregnancy loss, women who had undergone in vitro fertilization or women with thrombophilia or antiphospholipid syndrome was associated with a non-significant decrease in the risk of preeclampsia, gestational hypertension, and any hypertensive disorder of pregnancy. • Early low-dose aspirin reduced the risk of preterm delivery but had no impact on the risk of fetal growth restriction. • Except for preterm delivery and any hypertensive disorder of pregnancy, sensitivity analysis demonstrated similar observations; confirming the robustness of our analysis. What does this add to what is known? • Administration of low-dose aspirin at <11 weeks' gestation to high risk women does not reduce the risk of preeclampsia, gestational hypertension, any hypertensive disorder of pregnancy and fetal growth restriction but might reduce the risk of preterm delivery at <37 weeks of gestation. ABSTRACT OBJECTIVE DATA: Pre-conception or early administration of low-dose aspirin might improve endometrial growth, placental vascularization and organogenesis. Most studies have evaluated the potential benefit of pre-conception or early administration of low-dose aspirin in women with a history of recurrent pregnancy loss, women who have undergone in vitro fertilization or women with thrombophilia or antiphospholipid syndrome. These women are at an increased risk of placenta-associated complications of pregnancy, including preeclampsia, preterm delivery and fetal growth restriction. STUDY: We performed a systematic review and meta-analysis to evaluate the effect of low-dose aspirin initiated at <11 weeks' gestation on the risk of preeclampsia, gestational hypertension, or any hypertensive disorder of pregnancy. Secondary outcomes included preterm delivery at <37 weeks' gestation and fetal growth restriction. STUDY APPRAISAL AND SYNTHESIS METHODS: We searched in MEDLINE via PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.Gov and the World Health Organization International Clinical Trials Registry Platform (WHO-ICTRP) from 1985 to November 2018. Entry criteria were randomized controlled trials evaluating the effect of aspirin administered at <11 weeks' gestation in preventing preeclampsia and/or hypertensive disorders in pregnancy or improvi...

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Risk of spontaneous preterm birth in singleton pregnancies conceived after IVF/ICSI treatment: meta‐analysis of cohort studies

Abstract: Objective Preterm birth (PTB) is more common in pregnancies conceived by in-vitro

Cited by 167 publications

References 45 publications

Outcomes of pulmonary vascular disease in infants conceived with non‐IVF fertility treatment and assisted reproductive technologies at 1 year of age

Outcomes of pulmonary vascular disease in infants conceived with non‐IVF fertility treatment and assisted reproductive technologies at 1 year of age

Outcome of ICSI pregnancies with spontaneous loss of a co‐twin compared with singleton ICSI pregnancies: Single center experience

Does low-dose aspirin initiated before 11 weeks’ gestation reduce the rate of preeclampsia?

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