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

  • Assisted Reproduction Technologies
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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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Acknowledgments

The SART wishes to thank all of its members for providing clinical information to the SART CORS database for use by patients and researchers. Without the efforts of our members, this research would not have been possible. The project described was supported by grant R01HD067270 from the National Institute of Child Health and Human Development. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Child Health and Human Development or the National Institutes of Health.

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Authors and Affiliations

  1. Department of Obstetrics, Gynecology, and Reproductive Biology, College of Human Medicine, Michigan State University, 965 Fee Road, East Fee Hall, Room 628, East Lansing, MI, USA

    Barbara Luke

  2. Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA

    Daksha Gopal

  3. Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA

    Howard Cabral

  4. Massachusetts Department of Public Health, Boston, MA, USA

    Hafsatou Diop

  5. Department of Obstetrics and Gynecology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA

    Judy E. Stern

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  1. Barbara Luke
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  2. Daksha Gopal
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  3. Howard Cabral
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  4. Hafsatou Diop
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  5. Judy E. Stern
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Correspondence to Barbara Luke.

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Conflict of interest

Barbara Luke is a research consultant to the Society for Assisted Reproductive Technology; all other authors report no conflict of interest.

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Capsule

Declining fertility status, with and without assisted reproductive technology treatment, is associated with increased risk for adverse outcomes.

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Luke, B., Gopal, D., Cabral, H. et al. Perinatal outcomes of singleton siblings: the effects of changing maternal fertility status. J Assist Reprod Genet 33, 1203–1213 (2016). https://doi.org/10.1007/s10815-016-0757-6

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  • DOI: https://doi.org/10.1007/s10815-016-0757-6

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