Risk of prematurity and infant morbidity and mortality by maternal fertility status and plurality

Barbara Luke, Morton B. Brown, Ethan Wantman, David B. Seifer, Amy T. Sparks, Paul C. Lin, Kevin J. Doody, Bradley J. Van Voorhis, Logan G Spector

Research output: Contribution to journalArticle

Abstract

Purpose: To evaluate the risk of prematurity and infant mortality by maternal fertility status, and for in vitro fertilization (IVF) pregnancies, by oocyte source and embryo state combinations. Methods: Women in 14 States who had IVF-conceived live births during 2004–13 were linked to their infant’s birth and death certificates; a 10:1 sample of non-IVF births was selected for comparison; those with an indication of infertility treatment on the birth certificate were categorized as subfertile, all others were categorized as fertile. Risks were modeled separately for the fertile/subfertile/IVF (autologous-fresh only) group and for the IVF group by oocyte source-embryo state combinations, using logistic regression, and reported as adjusted odds ratios (AORs) and 95% confidence intervals (CI). Results: The study population included 2,474,195 pregnancies. Placental complications (placenta previa, abruptio placenta, and other excessive bleeding) and prematurity were both increased with pregestational and gestational diabetes and hypertension, among subfertile and IVF groups, and in IVF pregnancies using donor oocytes. Both subfertile and IVF pregnancies were at risk for prematurity and NICU admission; IVF infants were also at risk for small-for-gestation birthweight, and subfertile infants had greater risks for neonatal and infant death. Within the IVF group, pregnancies with donor oocytes and/or thawed embryos were at greater risk of large-for-gestation birthweight, and pregnancies with thawed embryos were at greater risk of neonatal and infant death. Conclusions: Prematurity was associated with placental complications, diabetes and hypertension, subfertility and IVF groups, and in IVF pregnancies, donor oocytes and/or thawed embryos.

Original languageEnglish (US)
Pages (from-to)121-138
Number of pages18
JournalJournal of Assisted Reproduction and Genetics
Volume36
Issue number1
DOIs
StatePublished - Jan 15 2019

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Infant Mortality
Fertilization in Vitro
Fertility
Mothers
Morbidity
Pregnancy
Oocytes
Embryonic Structures
Birth Certificates
Tissue Donors
Infertility
Placenta Previa
Abruptio Placentae
Pregnancy Induced Hypertension
Death Certificates
Gestational Diabetes
Live Birth
Diabetes Complications
Fertilization
Logistic Models

Keywords

  • Embryo state
  • Fertility status
  • Infant morbidity
  • Infant mortality
  • Oocyte source
  • Placental complications
  • Prematurity

PubMed: MeSH publication types

  • Journal Article

Cite this

Risk of prematurity and infant morbidity and mortality by maternal fertility status and plurality. / Luke, Barbara; Brown, Morton B.; Wantman, Ethan; Seifer, David B.; Sparks, Amy T.; Lin, Paul C.; Doody, Kevin J.; Van Voorhis, Bradley J.; Spector, Logan G.

In: Journal of Assisted Reproduction and Genetics, Vol. 36, No. 1, 15.01.2019, p. 121-138.

Research output: Contribution to journalArticle

Luke, B, Brown, MB, Wantman, E, Seifer, DB, Sparks, AT, Lin, PC, Doody, KJ, Van Voorhis, BJ & Spector, LG 2019, 'Risk of prematurity and infant morbidity and mortality by maternal fertility status and plurality', Journal of Assisted Reproduction and Genetics, vol. 36, no. 1, pp. 121-138. https://doi.org/10.1007/s10815-018-1333-z
Luke, Barbara ; Brown, Morton B. ; Wantman, Ethan ; Seifer, David B. ; Sparks, Amy T. ; Lin, Paul C. ; Doody, Kevin J. ; Van Voorhis, Bradley J. ; Spector, Logan G. / Risk of prematurity and infant morbidity and mortality by maternal fertility status and plurality. In: Journal of Assisted Reproduction and Genetics. 2019 ; Vol. 36, No. 1. pp. 121-138.
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abstract = "Purpose: To evaluate the risk of prematurity and infant mortality by maternal fertility status, and for in vitro fertilization (IVF) pregnancies, by oocyte source and embryo state combinations. Methods: Women in 14 States who had IVF-conceived live births during 2004–13 were linked to their infant’s birth and death certificates; a 10:1 sample of non-IVF births was selected for comparison; those with an indication of infertility treatment on the birth certificate were categorized as subfertile, all others were categorized as fertile. Risks were modeled separately for the fertile/subfertile/IVF (autologous-fresh only) group and for the IVF group by oocyte source-embryo state combinations, using logistic regression, and reported as adjusted odds ratios (AORs) and 95{\%} confidence intervals (CI). Results: The study population included 2,474,195 pregnancies. Placental complications (placenta previa, abruptio placenta, and other excessive bleeding) and prematurity were both increased with pregestational and gestational diabetes and hypertension, among subfertile and IVF groups, and in IVF pregnancies using donor oocytes. Both subfertile and IVF pregnancies were at risk for prematurity and NICU admission; IVF infants were also at risk for small-for-gestation birthweight, and subfertile infants had greater risks for neonatal and infant death. Within the IVF group, pregnancies with donor oocytes and/or thawed embryos were at greater risk of large-for-gestation birthweight, and pregnancies with thawed embryos were at greater risk of neonatal and infant death. Conclusions: Prematurity was associated with placental complications, diabetes and hypertension, subfertility and IVF groups, and in IVF pregnancies, donor oocytes and/or thawed embryos.",
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AU - Luke, Barbara

AU - Brown, Morton B.

AU - Wantman, Ethan

AU - Seifer, David B.

AU - Sparks, Amy T.

AU - Lin, Paul C.

AU - Doody, Kevin J.

AU - Van Voorhis, Bradley J.

AU - Spector, Logan G

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AB - Purpose: To evaluate the risk of prematurity and infant mortality by maternal fertility status, and for in vitro fertilization (IVF) pregnancies, by oocyte source and embryo state combinations. Methods: Women in 14 States who had IVF-conceived live births during 2004–13 were linked to their infant’s birth and death certificates; a 10:1 sample of non-IVF births was selected for comparison; those with an indication of infertility treatment on the birth certificate were categorized as subfertile, all others were categorized as fertile. Risks were modeled separately for the fertile/subfertile/IVF (autologous-fresh only) group and for the IVF group by oocyte source-embryo state combinations, using logistic regression, and reported as adjusted odds ratios (AORs) and 95% confidence intervals (CI). Results: The study population included 2,474,195 pregnancies. Placental complications (placenta previa, abruptio placenta, and other excessive bleeding) and prematurity were both increased with pregestational and gestational diabetes and hypertension, among subfertile and IVF groups, and in IVF pregnancies using donor oocytes. Both subfertile and IVF pregnancies were at risk for prematurity and NICU admission; IVF infants were also at risk for small-for-gestation birthweight, and subfertile infants had greater risks for neonatal and infant death. Within the IVF group, pregnancies with donor oocytes and/or thawed embryos were at greater risk of large-for-gestation birthweight, and pregnancies with thawed embryos were at greater risk of neonatal and infant death. Conclusions: Prematurity was associated with placental complications, diabetes and hypertension, subfertility and IVF groups, and in IVF pregnancies, donor oocytes and/or thawed embryos.

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KW - Fertility status

KW - Infant morbidity

KW - Infant mortality

KW - Oocyte source

KW - Placental complications

KW - Prematurity

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