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Journal of Assisted Reproduction and Genetics
Published in: Journal of Assisted Reproduction and Genetics 9/2016

01-09-2016 | Assisted Reproduction Technologies

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

Authors: Barbara Luke, Daksha Gopal, Howard Cabral, Hafsatou Diop, Judy E. Stern

Published in: Journal of Assisted Reproduction and Genetics | Issue 9/2016

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Abstract

Purpose

The objective of this study was to evaluate the effect of changing fertility status on perinatal outcomes of singleton siblings, conceived with and without assisted reproductive technology (ART).

Method

A longitudinal cohort study of Massachusetts resident women having two consecutive singleton births during 2004–2010 was performed. Women were classified as ART (A), subfertile (S), or fertile (F) and categorized by their fertility status in each birth as A-A, A-S, S-A, S-S, F-A, F-S, and F-F. Within categories, adjusted mean birthweights, gestations, and birthweight Z scores were estimated with linear generalized estimating equations. Risks of low birthweight (LBW, <2500 g), preterm birth (PTB, <37 weeks), and placental complications were modeled using logistic regression by fertility status as adjusted odds ratios (AORs) and 95 % confidence intervals (CIs).

Results

Birthweights in second pregnancies averaged 74–155 g higher, except for births to F-A women, who averaged −16 g lower. Most women had a reduction in length of gestation in their second pregnancies, with F-A women having the largest decline (−0.5 weeks). In first birth models, the risks for LBW and placental complications were increased for subfertile (AOR 1.39 [1.07–1.81] and 1.97 [1.33–2.93], respectively) and ART women (AOR 1.58 [1.29–1.93] and 3.40 [2.64–4.37], respectively). Second birth models showed increased risks for ART births of LBW (AOR 3.13 [2.19–4.48]) and placental complications (AOR 2.45 [1.56–3.86]) and greater risks of PTB for both ART (AOR 2.37 [1.74–3.23]) and subfertile women (AOR 1.47 [1.02–2.13]).

Conclusions

Declining fertility status, with and without assisted reproductive technology treatment, is associated with increasing risks for adverse outcomes, greatest for women whose fertility status declined the most.
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Metadata
Title
Perinatal outcomes of singleton siblings: the effects of changing maternal fertility status
Authors
Barbara Luke
Daksha Gopal
Howard Cabral
Hafsatou Diop
Judy E. Stern
Publication date
01-09-2016
Publisher
Springer US
Published in
Journal of Assisted Reproduction and Genetics / Issue 9/2016
Print ISSN: 1058-0468
Electronic ISSN: 1573-7330
DOI
https://doi.org/10.1007/s10815-016-0757-6

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