Document Detail


Infertility, infertility treatment, and fetal growth restriction.
MedLine Citation:
PMID:  18055728     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To examine the association between infertility, with or without treatment, and fetal growth, as well as perinatal and infant mortality.
METHODS: From the Danish National Birth Cohort (1997-2003), we identified 51,041 singletons born of fertile couples (time to pregnancy 12 months or less), 5,787 born of infertile couples conceiving naturally (time to pregnancy more than 12 months), and 4,317 born after treatment. We defined small for gestational age (SGA) as the lowest 5% of birth weight by sex and gestational age.
RESULTS: Crude estimates suggested an increased risk of perinatal mortality and SGA among infertile couples (treated and untreated), but the odds ratios (ORs) of perinatal mortality among infertile couples were attenuated after adjustment for maternal age and body mass index (1.32, 95% confidence interval [CI] 0.95-1.84 among untreated and 1.26, 95% CI 0.86-1.85 among treated couples). The elevated risk of SGA among infertile couples persisted after adjustment for maternal age, parity, and smoking (OR 1.24, 95% CI 1.10-1.40 among untreated, and OR 1.40, 95% CI 1.23-1.60 among treated). The risk of SGA increased with time to pregnancy, and a longer time to pregnancy was associated with a small reduction in birth weight across the whole distribution.
CONCLUSION: The increased risk of SGA observed among infertile couples with or without infertility treatment suggests that infertility may be a risk factor for intrauterine growth restriction. Treatment per se may have little effect on fetal growth. A small-to-moderate increased risk of perinatal mortality in infertile couples cannot be ruled out due to the small number of cases.
LEVEL OF EVIDENCE: II.
Authors:
Jin Liang Zhu; Carsten Obel; Bodil Hammer Bech; Jørn Olsen; Olga Basso
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Intramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  110     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-12-06     Completed Date:  2008-01-17     Revised Date:  2012-03-07    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1326-34     Citation Subset:  AIM; IM    
Affiliation:
Department of Epidemiology, Institute of Public Health, University of Aarhus, Aarhus C, Denmark. zjl@soci.au.dk
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MeSH Terms
Descriptor/Qualifier:
Adult
Case-Control Studies
Cohort Studies
Denmark / epidemiology
Female
Fetal Growth Retardation / epidemiology*
Humans
Infant Mortality
Infant, Newborn
Infant, Small for Gestational Age*
Infertility, Female / complications*,  therapy
Odds Ratio
Pregnancy
Reproductive Techniques, Assisted
Risk Factors
Grant Support
ID/Acronym/Agency:
Z99 ES999999/ES/NIEHS NIH HHS
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