Journal of Assisted Reproduction and Genetics

, Volume 33, Issue 9, pp 1203–1213 | Cite as

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

  • Barbara LukeEmail author
  • Daksha Gopal
  • Howard Cabral
  • Hafsatou Diop
  • Judy E. Stern
Assisted Reproduction Technologies



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).


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).


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]).


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.


Fertile Subfertile Assisted reproductive technology Infertility Adverse pregnancy outcomes 



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.

Compliance with ethical standards

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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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Department of Obstetrics, Gynecology, and Reproductive Biology, College of Human MedicineMichigan State UniversityEast LansingUSA
  2. 2.Department of Community Health SciencesBoston University School of Public HealthBostonUSA
  3. 3.Department of BiostatisticsBoston University School of Public HealthBostonUSA
  4. 4.Massachusetts Department of Public HealthBostonUSA
  5. 5.Department of Obstetrics and GynecologyGeisel School of Medicine at DartmouthLebanonUSA

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