University of Leicester
Browse
ART and perinatal outcomes_fertilsteril_revision3_ clean.pdf (1.04 MB)

Assisted Reproductive Technology and Perinatal Outcomes: Conventional versus discordant sibling design

Download (1.04 MB)
journal contribution
posted on 2016-05-12, 09:05 authored by Nafeesa N. Dhalwani, Sheree L. Boulet, Dmitry M. Kissin, Yujia Zhang, Patricia McKane, Marie A. Bailey, Maria-Elena (Malena) Hood, Laila J. Tata
Objective: To compare risks of adverse perinatal outcomes between Assisted Reproductive Technology (ART) and naturally conceived singleton births using a dual design approach. Study design: Discordant sibling and conventional cross-sectional general population comparison. Setting: National ART Surveillance System from Michigan, Massachusetts and Florida (2000-2010) linked to birth records. Patients: all singleton live births, conceived naturally or via ART Interventions: None Main outcome measures: Birthweight, gestational age, low birthweight, preterm delivery, small-for-gestational age (SGA), low Apgar score. Results: 32,762(0.8%) of 3,896,242 singleton live births in the three states were conceived via ART. In 6,458 sibling pairs, ART conceived singletons were 33g lighter (Adjusted β=-33.40, 95% Confidence Interval (CI) -48.60,-18.21) and born half a day sooner (β=-0.58, 95% CI -1.02,-0.14) than singletons conceived naturally. The absolute risk of low birth weight and preterm birth was 6.8% and 9.7% respectively in the ART group and 4.9% and 7.9% in the non-ART group respectively. The odds of low birthweight were 33% higher (Adjusted Odds Ratio (aOR) =1.33, 95% CI 1.13, 1.56) and 20% higher for preterm birth (aOR=1.20, 95% CI 1.07, 1.34). The odds of SGA and low Apgar score were not significantly different in both the groups (aOR=1.22, 95% CI 0.88, 1.68 and aOR=0.75, 95% CI 0.54, 1.05 respectively). Results of conventional analyses were similar, although the magnitude of risk was higher for pre-term birth (aOR 1.51, 95% CI 1.46, 1.56). Conclusion: Despite some inflated risks in the general population comparison, ART remained associated with increased likelihood of low birthweight and preterm birth when underlying maternal factors were kept constant using discordant-sibling comparison.

History

Citation

Fertility & Sterility, 2016, 106 (3), pp. 710–716.e2

Author affiliation

/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY/School of Medicine

Version

  • AM (Accepted Manuscript)

Published in

Fertility & Sterility

Publisher

Elsevier on behalf of American Society for Reproductive Medicine

issn

0015-0282

eissn

1556-5653

Acceptance date

2016-04-25

Copyright date

2016

Available date

2017-05-14

Publisher version

http://www.fertstert.org/

Notes

The file associated with this record is embargoed until 12 months after the date of publication. The final published version may be available through the links above.

Language

en

Usage metrics

    University of Leicester Publications

    Categories

    Exports

    RefWorks
    BibTeX
    Ref. manager
    Endnote
    DataCite
    NLM
    DC