Assisted Reproduction and Neonatal Outcome

Excerpt

Assisted reproductive techniques (ART) account for an increasing proportion of live births with numbers almost doubling from about 230,000 in 2003 to 439,000 in 2014 [1, 2]. Although both the proportion among live births and the absolute numbers are low in India, the rate of increase is much higher (from 4212 in 2003 to 14325 in 2014). Neonates born after ART have a higher incidence of adverse perinatal and neonatal outcomes due to an increased risk of premature birth [3]. Multiple gestation is the single most important reason for premature birth after ART. However, the risk of preterm birth is higher even in singleton pregnancies conceived after ART. Other reasons for prematurity in ART pregnancies include a higher incidence of placenta previa and iatrogenic prematurity due to labor induction or elective cesarean section at a lower gestation [3]. An increased risk of adverse outcomes in ART pregnancies has been reported, even in neonates born at term gestation. Contributory factors include a higher incidence of fetal growth restriction (FGR) and congenital malformations [4]. Hypotheses raised to explain the poor outcome also include the effect of the specific technique of assisted reproduction on the embryo and the altered metabolic–endocrinal milieu of the mother due to infertility and artificial ovarian stimulation. …