To determine whether adverse perinatal outcomes are increased in subfertile women.
Cohort study.
Two tertiary assisted reproductive technologies (ART) centers; Victorian births register.
Records of women who registered with the clinics (1991-2000), but did not have an
infant using ART, were linked to the birth register (1991-2004) to identify singleton
non-ART births within 5 years of registration (N = 2171). Controls, matched by maternal
age and year of infant's birth, were selected randomly from birth records (N = 4363).
None.
Adverse obstetric and perinatal outcomes.
After adjusting for confounders, compared with controls, subfertile women had increased
odds of hypertension or preeclampsia (adjusted odds ratio [OR] 1.29, 1.02-1.61), antepartum
hemorrhage (adjusted OR 1.41, 1.05-1.89), perinatal death (adjusted OR 2.19, 1.10-4.36),
low birth weight (adjusted OR 1.44, 1.11-1.85), preterm birth <37 weeks (adjusted
OR 1.32, 1.05-1.67) or <31 weeks (adjusted OR 2.37, 1.35-4.13), and cesarean delivery
(adjusted OR 1.56, 1.37-1.77). There was weak evidence for increased birth defects
(adjusted OR 1.30, 0.98-1.72) and gestational diabetes (adjusted OR 1.25, 0.96-1.63).
No increased risk was found for prelabor rupture of membranes, small for gestational
age, or postpartum hemorrhage.
Subfertile women with singleton births are at increased risk of several adverse outcomes.
These risks should be considered during their antenatal care and when analyzing adverse
effects of ART.
Copyright © 2010 American Society for Reproductive Medicine. Published by Elsevier
Inc. All rights reserved.