Top

Archives of Gynecology and Obstetrics

Published in:

01-07-2017 | Gynecologic Endocrinology and Reproductive Medicine

Obstetrical and perinatal morbidity and mortality among in-vitro fertilization pregnancies: a population-based study

Authors: Hussein Sabban, Andrew Zakhari, Valerie Patenaude, Togas Tulandi, Haim A. Abenhaim

Published in: Archives of Gynecology and Obstetrics | Issue 1/2017

Abstract

Purpose

To compare patient characteristics and obstetrical/neonatal outcomes of in-vitro fertilization (IVF) and spontaneously conceived pregnancies.

Methods

Using the Nationwide Inpatient Sample, we conducted a retrospective cohort study from 2008 to 2011 comparing IVF conceptions to spontaneous ones. Patient characteristics were descriptively compared, and after adjusting for baseline characteristics with logistic regression, obstetrical/neonatal outcomes were also compared.

Results

Among 3,315,764 pregnancies, 5773 (0.17%) were a result of IVF. These patients were more often older, wealthier, Caucasian, non-smokers, and more likely to carry a higher order pregnancy. IVF was strongly associated with pre-eclampsia (OR 1.48, 95% CI 1.32–1.62), gestational diabetes (OR 1.27, 95% CI 1.17–1.38), antepartum hemorrhage (OR 2.04, 95% CI 1.79–2.32), placenta previa (OR 3.14, 95% CI 2.71–3.64), pre-term premature rupture of membranes (OR 1.49, 95% CI 1.30–1.70), chorioamnionitis (OR 1.52, 1.29–1.79), and cesarean section (OR 1.60, 95% CI 1.51–1.70). There was a significantly increased risk of post-partum hemorrhage (OR 2.95, 95% CI 2.29–3.80) and hysterectomy (OR 1.73, 95% CI 1.12–2.69), as well as disseminated intravascular coagulopathy (OR 2.23, 95% CI 1.24–3.99), transfusion (OR 1.78, 95% CI 1.53–2.07), prolonged hospitalization (OR 1.96, 95% CI 1.80–2.14), intrauterine growth restriction (OR 1.81, 95% CI 1.63–2.02), and pre-term birth (OR 1.31, 95% CI 1.22–1.41).

Conclusion

IVF is still primarily used by only a subset of the population, and is associated with increased obstetrical and perinatal morbidity and mortality. These patients may benefit from more vigilant antenatal surveillance and delivery in a tertiary care center.

Sunderam S, Kissin DM, Crawford SB, Folger SG, Jamieson DJ, Warner L et al (2017) Assisted reproductive technology surveillance—United States, 2014. Morb Mortal Wkly Rep Surveill Summ (Washington, DC : 2002) 66(6):1–24

Jackson RA, Gibson KA, Wu YW, Croughan MS (2004) Perinatal outcomes in singletons following in vitro fertilization: a meta-analysis. Obstet Gynecol 103(3):551–563CrossRefPubMed

Källén B, Finnström O, Nygren K, Otterblad Olausson P, Wennerholm UB (2005) In vitro fertilisation in Sweden: obstetric characteristics, maternal morbidity and mortality. BJOG Int J Obstet Gynaecol 112(11):1529–1535CrossRef

Zhu L, Zhang Y, Liu Y, Zhang R, Wu Y, Huang Y et al (2016) Maternal and live-birth outcomes of pregnancies following assisted reproductive technology: a retrospective cohort study. Sci Rep 6:35141CrossRefPubMedPubMedCentral

Qin JB, Sheng XQ, Wu D, Gao SY, You YP, Yang TB et al (2017) Worldwide prevalence of adverse pregnancy outcomes among singleton pregnancies after in vitro fertilization/intracytoplasmic sperm injection: a systematic review and meta-analysis. Arch Gynecol Obstet 295(2):285–301CrossRefPubMed

Schieve LA, Cohen B, Nannini A, Ferre C, Reynolds MA, Zhang Z et al (2007) A population-based study of maternal and perinatal outcomes associated with assisted reproductive technology in Massachusetts. Matern Child Health J 11(6):517–525CrossRefPubMed

Fong A, Johnston R, Rad S, Turner A, Pan D, Ogunyemi DA (2014) Demographic and medical disparities in assisted reproductive technology compared with non-assisted reproductive technology pregnancies. Obstet Gynecol 123:50SCrossRef

Hammoud AO, Gibson M, Stanford J, White G, Carrell DT, Peterson M (2009) In vitro fertilization availability and utilization in the United States: a study of demographic, social, and economic factors. Fertil Steril 91(5):1630–1635CrossRefPubMed

Jain T, Harlow BL, Hornstein MD (2002) Insurance coverage and outcomes of in vitro fertilization. N Engl J Med 347(9):661–666CrossRefPubMed

10.

Jain T (2006) Socioeconomic and racial disparities among infertility patients seeking care. Fertil Steril 85(4):876–881CrossRefPubMed

11.

Chin HB, Howards PP, Kramer MR (2015) Racial disparities in seeking care for help getting pregnant. Paediatr Perinat Epidemiol 29(5):416–425CrossRefPubMedPubMedCentral

12.

Inhorn MC, Fakih MH (2006) Arab Americans, African Americans, and infertility: barriers to reproduction and medical care. Fertil Steril 85(4):844–852CrossRefPubMed

13.

Finnström O, Källén B, Lindam A, Nilsson E, Nygren KG, Olausson PO (2011) Maternal and child outcome after in vitro fertilization–a review of 25 years of population-based data from Sweden. Acta Obstet Gynecol Scand 90(5):494–500CrossRefPubMed

14.

Wisborg K, Ingerslev HJ, Henriksen TB (2010) IVF and stillbirth: a prospective follow-up study. Hum Reprod 25(5):1312–1316CrossRefPubMed

15.

Neumann K, Cirkel C, Rody A, Beyer DA (2017) Do ART patients face higher C-section rates during their stage of delivery? A German monocenter experience. Arch Gynecol Obstet 295(2):481–485CrossRefPubMed

16.

Jaques AM, Amor DJ, Baker HG, Healy DL, Ukoumunne OC, Breheny S et al (2010) Adverse obstetric and perinatal outcomes in subfertile women conceiving without assisted reproductive technologies. Fertil Steril 94(7):2674–2679CrossRefPubMed

17.

Thomson F, Shanbhag S, Templeton A, Bhattacharya S (2005) Obstetric outcome in women with subfertility. BJOG Int J Obstet Gynaecol 112(5):632–637CrossRef

18.

Klemetti R, Sevón T, Gissler M, Hemminki E (2010) Health of children born after ovulation induction. Fertil Steril 93(4):1157–1168CrossRefPubMed

19.

Dunietz GL, Holzman C, McKane P, Li C, Boulet SL, Todem D et al (2015) Assisted reproductive technology and the risk of preterm birth among primiparas. Fertil Steril 103(4):974.e1–979.e1CrossRef

20.

Kalra SK, Ratcliffe SJ, Coutifaris C, Molinaro T, Barnhart KT (2011) Ovarian stimulation and low birth weight in infants conceived through in vitro fertilization. Obstet Gynecol 118(4):863CrossRefPubMedPubMedCentral

21.

Shih W, Rushford D, Bourne H, Garrett C, McBain J, Healy D et al (2008) Factors affecting low birthweight after assisted reproduction technology: difference between transfer of fresh and cryopreserved embryos suggests an adverse effect of oocyte collection. Hum Reprod 23(7):1644–1653CrossRefPubMed

22.

Kalra SK, Ratcliffe SJ, Milman L, Gracia CR, Coutifaris C, Barnhart KT (2011) Perinatal morbidity after in vitro fertilization is lower with frozen embryo transfer. Fertil Steril 95(2):548–553CrossRef

23.

Turan N, Katari S, Gerson LF, Chalian R, Foster MW, Gaughan JP et al (2010) Inter-and intra-individual variation in allele-specific DNA methylation and gene expression in children conceived using assisted reproductive technology. PLoS Genet 6(7):e1001033CrossRefPubMedPubMedCentral

24.

Imudia AN, Awonuga AO, Kaimal AJ, Wright DL, Styer AK, Toth TL (2013) Elective cryopreservation of all embryos with subsequent cryothaw embryo transfer in patients at risk for ovarian hyperstimulation syndrome reduces the risk of adverse obstetric outcomes: a preliminary study. Fertil Steril 99(1):168–173CrossRefPubMed

25.

Farhi J, Haroush AB, Andrawus N, Pinkas H, Sapir O, Fisch B et al (2010) High serum oestradiol concentrations in IVF cycles increase the risk of pregnancy complications related to abnormal placentation. Reprod Biomed Online 21(3):331–337CrossRefPubMed

26.

Imudia AN, Awonuga AO, Doyle JO, Kaimal AJ, Wright DL, Toth TL et al (2012) Peak serum estradiol level during controlled ovarian hyperstimulation is associated with increased risk of small for gestational age and preeclampsia in singleton pregnancies after in vitro fertilization. Fertil Steril 97(6):1374–1379CrossRefPubMed

27.

Schieve LA, Meikle SF, Ferre C, Peterson HB, Jeng G, Wilcox LS (2002) Low and very low birth weight in infants conceived with use of assisted reproductive technology. N Engl J Med 346(10):731–737CrossRefPubMed

28.

Qin J, Sheng X, Wu D, Gao S, You Y, Yang T et al (2017) Adverse obstetric outcomes associated with in vitro fertilization in singleton pregnancies. Reprod Sci (Thousand Oaks, Calif) 24(4):595–608CrossRef

29.

Tallo CP, Vohr B, Oh W, Rubin LP, Seifer DB, Haning RV (1995) Maternal and neonatal morbidity associated with in vitro fertilization. J Pediatr 127(5):794–800CrossRefPubMed

30.

Venn A, Hemminki E, Watson L, Bruinsma F, Healy D (2001) Mortality in a cohort of IVF patients. Hum Reprod 16(12):2691–2696CrossRefPubMed

31.

Braat D, Schutte J, Bernardus R, Mooij T, van Leeuwen F (2010) Maternal death related to IVF in the Netherlands 1984–2008. Hum Reprod 25(7):1782–1786CrossRefPubMed

Title: Obstetrical and perinatal morbidity and mortality among in-vitro fertilization pregnancies: a population-based study
Authors: Hussein Sabban
Andrew Zakhari
Valerie Patenaude
Togas Tulandi
Haim A. Abenhaim
Publication date: 01-07-2017
Publisher: Springer Berlin Heidelberg
Published in: Archives of Gynecology and Obstetrics / Issue 1/2017
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-017-4379-8

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Obstetrical and perinatal morbidity and mortality among in-vitro fertilization pregnancies: a population-based study

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2017

Increased retinol-free RBP4 contributes to insulin resistance in gestational diabetes mellitus

Liquid-based endometrial cytology associated with curettage in the investigation of endometrial carcinoma in a population of 1987 women

Response to the Letter to the Editor by Arndt van Ophoven

Effectiveness of the contemporary treatment of preterm labor: a comparison with a historical cohort

Factors affecting serum sclerostin in postmenopausal women

Endometrial thickness influences neonatal birth weight in pregnancies with obstetric complications achieved after fresh IVF–ICSI cycles