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Birth outcomes of singleton vaginal deliveries to ART-treated, subfertile, and fertile primiparous women

  • Assisted Reproduction Technologies
  • Published:
Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

Abstract

Purpose

To determine whether differences in birth outcomes among assisted reproductive technology (ART)-treated, subfertile, and fertile women exist in primiparous women with, singleton, vaginal deliveries.

Methods

Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS) data were linked to Massachusetts vital records and hospital discharges for deliveries between July 2004 and December 2010. Primiparous women with in-state vaginal deliveries, adequate prenatal care, and singleton birth at ≥ 20 weeks (n = 117,779) were classified as ART-treated (linked to ART data from SART CORS, n = 3138); subfertile (not ART-treated but with indicators of subfertility, n = 1507); or fertile (neither ART-treated nor subfertile, n = 113,134). Outcomes of prematurity (< 37 weeks), low birthweight (< 2500 g), perinatal death (death at ≥ 20 weeks to ≤ 7 days), and maternal prolonged length of hospital stay (LOS > 3 days) were compared using multivariable logistic regression.

Results

Compared to fertile, higher odds were found for prematurity among ART-treated (adjusted odds ratio [AOR] 1.40, 95% confidence interval [CI] 1.25–1.50) and subfertile (AOR 1.25, 95% CI 1.03–1.50) women, low birthweight among ART-treated (AOR 1.41, 95% CI 1.23–1.62) and subfertile (AOR 1.40, 95% CI 1.15–1.71) women, perinatal death among subfertile (AOR 2.64, 95% CI 1.72–4.05), and prolonged LOS among ART-treated (AOR 1.33, 95% CI 1.19–1.48) women. Differences remained despite stratification by young age and absence of pregnancy/delivery complications.

Conclusions

Greater odds of prematurity and low birthweight in ART-treated and subfertile, and perinatal death in subfertile deliveries are evident among singleton vaginal deliveries. The data suggest that even low-risk pregnancies to ART-treated and subfertile women be managed for adverse outcomes.

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Acknowledgments

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.

Funding

The work was funded by the National Institute of Child Health and Human Development (RO1HD067270).

Author information

Authors and Affiliations

  1. Department of Obstetrics & Gynecology and Pathology, Dartmouth-Hitchcock, One Medical Center Drive, Lebanon, NH, 03756, USA

    Judy E. Stern

  2. Mass Department of Public Health, Boston, MA, USA

    Chia-ling Liu & Hafsatou Diop

  3. Department of Biostatistics, Boston University, Boston, MA, USA

    Howard J. Cabral

  4. Department of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, OH, USA

    Elliott G. Richards

  5. Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN, USA

    Charles C. Coddington

  6. Section of Neonatology, Department of Pediatrics, University of Colorado School of Medicine, Aurora, USA

    Sunah Hwang

  7. Department of Pediatrics, Oregon Health & Science University, Portland, USA

    Dmitry Dukhovny

  8. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Stacey A. Missmer

  9. Department of Obstetrics, Gynecology and Reproductive Biology, Michigan State University, Grand Rapids, MI, USA

    Stacey A. Missmer

Authors
  1. Judy E. Stern
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  2. Chia-ling Liu
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  3. Howard J. Cabral
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  5. Charles C. Coddington
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  6. Sunah Hwang
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  7. Dmitry Dukhovny
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  8. Hafsatou Diop
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  9. Stacey A. Missmer
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Corresponding author

Correspondence to Judy E. Stern.

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Institutional review board approval was obtained from MDPH and the Committee for the Protection of Human Subjects at Dartmouth College.

Additional information

Presented as an abstract at the American Society for Reproductive Medicine Annual Meeting, October 29–November 1, 2017.

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Stern, J.E., Liu, Cl., Cabral, H.J. et al. Birth outcomes of singleton vaginal deliveries to ART-treated, subfertile, and fertile primiparous women. J Assist Reprod Genet 35, 1585–1593 (2018). https://doi.org/10.1007/s10815-018-1238-x

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  • DOI: https://doi.org/10.1007/s10815-018-1238-x

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