Document Detail

A population-based study of maternal and perinatal outcomes associated with assisted reproductive technology in Massachusetts.
MedLine Citation:
PMID:  17345154     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To assess associations between assisted reproductive technology (ART) and adverse maternal and infant outcomes, with an emphasis on singletons. METHODS: We linked data from the US ART surveillance system with Massachusetts live birth-infant death records data for resident births in 1997-1998 and compared births conceived with ART (N = 3316) with births not conceived with ART or infertility medications (N = 157,066) on: maternal chronic conditions, pregnancy complications, labor and delivery complications, and perinatal and infant outcomes. RESULTS: Overall, ART was strongly associated with numerous adverse outcomes. The magnitude was reduced for several outcomes when analyses were limited to singletons. After further exclusion of maternal subsets with rare ART births (maternal age <20; education <high school; unmarried, no or public health insurance; no or third trimester prenatal care initiation), and matching ART and non-ART singletons on birth hospital, birth month and year, maternal age, parity, and race/ethnicity, ART remained associated with pre-existing diabetes (Relative Risk [RR] = 2.2 95% confidence interval 1.02-4.9), incompetent cervix (RR = 6.0, [2.3-15.4]), pregnancy-induced hypertension (RR = 1.5, [1.04-2.2]), uterine bleeding (RR = 3.2, [1.5-6.8]), placental abruption (RR = 3.8 [1.6-9.4]), placenta previa (RR = 3.8, [1.6-9.4]), preterm delivery (RR = 2.4, [1.8-3.0]), very preterm delivery (RR = 2.5, [1.2-5.2]), low birth weight (RR = 2.1, [1.5-2.9]), and infant not discharged home (RR = 1.8, [1.2-2.6]). CONCLUSIONS: Women who conceive with ART are more likely than women who do not to enter pregnancy with a chronic condition and develop complications during pregnancy and labor and delivery. Additionally, infants born after ART are at increased risk for adverse health outcomes. The mechanisms underlying these associations require further study.
Laura A Schieve; Bruce Cohen; Angela Nannini; Cynthia Ferre; Meredith A Reynolds; Zi Zhang; Gary Jeng; Maurizio Macaluso; Victoria C Wright;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.     Date:  2007-03-08
Journal Detail:
Title:  Maternal and child health journal     Volume:  11     ISSN:  1092-7875     ISO Abbreviation:  Matern Child Health J     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-10-31     Completed Date:  2008-02-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9715672     Medline TA:  Matern Child Health J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  517-25     Citation Subset:  IM    
Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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MeSH Terms
Case-Control Studies
Cross-Sectional Studies
Infant, Low Birth Weight*
Infant, Newborn
Massachusetts / epidemiology
Pregnancy Outcome / epidemiology*
Pregnancy in Diabetics*
Pregnancy, Multiple
Premature Birth*
Reproductive Techniques, Assisted / adverse effects*
Uterine Cervical Incompetence*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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