Effects of technology or maternal factors on perinatal outcome after assisted fertilisation: a population-based cohort study
Summary Background Research suggests that singleton births following assisted fertilisation are associated with adverse outcomes; however, these results might be confounded by factors that affect both fertility and pregnancy outcome. We therefore compared pregnancy outcomes in women who had singleto...
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| Veröffentlicht in: | The Lancet (British edition) 2008-08, Vol.372 (9640), p.737-743 |
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| creator | Romundstad, Liv Bente, Dr Romundstad, Pål R, PhD Sunde, Arne, Prof von Düring, Vidar, MD Skjærven, Rolv, Prof Gunnell, David, Prof Vatten, Lars J, Prof |
| description | Summary Background Research suggests that singleton births following assisted fertilisation are associated with adverse outcomes; however, these results might be confounded by factors that affect both fertility and pregnancy outcome. We therefore compared pregnancy outcomes in women who had singleton pregnancies conceived both spontaneously and after assisted fertilisation. Methods In a population-based cohort study, we assessed differences in birthweight, gestational age, and odds ratios (OR) of small for gestational age babies, premature births, and perinatal deaths in singletons (gestation ≥22 weeks or birthweigh ≥500 g) born to 2546 Norwegian women (>20 years) who had conceived at least one child spontaneously and another after assisted fertilisation among 1 200 922 births after spontaneous conception and 8229 after assisted fertilisation. Findings In the whole study population, assisted-fertilisation conceptions were associated with lower mean birthweight (difference 25 g, 95% CI 14 to 35), shorter duration of gestation (2·0 days, 1·6 to 2·3) and increased risks of small for gestational age (OR 1·26, 1·10 to 1·44), and perinatal death (1·31, 1·05 to 1·65) than were spontaneous conceptions. In the sibling-relationship comparisons, the spontaneous versus the assisted-fertilisation conceptions showed a difference of only 9 g (−18 to 36) in birthweight and 0·6 days (−0·5 to 1·7) in gestational age. For assisted fertilisation versus spontaneous conception in the sibling-relationship comparisons, the OR for small for gestational age was 0·99 (0·62 to 1·57) and that for perinatal mortality was 0·36 (0·20 to 0·67). Interpretation Birthweight, gestational age, and risks of small for gestational age babies, and preterm delivery did not differ among infants of women who had conceived both spontaneously and after assisted fertilisation. The adverse outcomes of assisted fertilisation that we noted compared with those in the general population could therefore be attributable to the factors leading to infertility, rather than to factors related to the reproductive technology. Funding St Olavs University Hospital, Trondheim, Norway, and the Norwegian Research Council. |
| doi_str_mv | 10.1016/S0140-6736(08)61041-7 |
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We therefore compared pregnancy outcomes in women who had singleton pregnancies conceived both spontaneously and after assisted fertilisation. Methods In a population-based cohort study, we assessed differences in birthweight, gestational age, and odds ratios (OR) of small for gestational age babies, premature births, and perinatal deaths in singletons (gestation ≥22 weeks or birthweigh ≥500 g) born to 2546 Norwegian women (>20 years) who had conceived at least one child spontaneously and another after assisted fertilisation among 1 200 922 births after spontaneous conception and 8229 after assisted fertilisation. Findings In the whole study population, assisted-fertilisation conceptions were associated with lower mean birthweight (difference 25 g, 95% CI 14 to 35), shorter duration of gestation (2·0 days, 1·6 to 2·3) and increased risks of small for gestational age (OR 1·26, 1·10 to 1·44), and perinatal death (1·31, 1·05 to 1·65) than were spontaneous conceptions. In the sibling-relationship comparisons, the spontaneous versus the assisted-fertilisation conceptions showed a difference of only 9 g (−18 to 36) in birthweight and 0·6 days (−0·5 to 1·7) in gestational age. For assisted fertilisation versus spontaneous conception in the sibling-relationship comparisons, the OR for small for gestational age was 0·99 (0·62 to 1·57) and that for perinatal mortality was 0·36 (0·20 to 0·67). Interpretation Birthweight, gestational age, and risks of small for gestational age babies, and preterm delivery did not differ among infants of women who had conceived both spontaneously and after assisted fertilisation. The adverse outcomes of assisted fertilisation that we noted compared with those in the general population could therefore be attributable to the factors leading to infertility, rather than to factors related to the reproductive technology. Funding St Olavs University Hospital, Trondheim, Norway, and the Norwegian Research Council.</description><identifier>ISSN: 0140-6736</identifier><identifier>EISSN: 1474-547X</identifier><identifier>DOI: 10.1016/S0140-6736(08)61041-7</identifier><identifier>PMID: 18674812</identifier><identifier>CODEN: LANCAO</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adult ; Birth Weight ; Cohort Studies ; Embryos ; Female ; Fertility ; Gestational Age ; Humans ; Industrialized nations ; Infertility ; Internal Medicine ; Linear Models ; Maternal Welfare ; Norway ; Parity ; Population ; Pregnancy ; Pregnancy Outcome ; Registries ; Reproductive Techniques, Assisted - adverse effects ; Reproductive technologies ; Studies ; Technology</subject><ispartof>The Lancet (British edition), 2008-08, Vol.372 (9640), p.737-743</ispartof><rights>Elsevier Ltd</rights><rights>2008 Elsevier Ltd</rights><rights>Copyright Elsevier Limited Aug 30-Sep 5, 2008</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c497t-a83b68f18a27474914beb33a5c56e115cbbd22437a125eae89d07ee06aae2a3b3</citedby><cites>FETCH-LOGICAL-c497t-a83b68f18a27474914beb33a5c56e115cbbd22437a125eae89d07ee06aae2a3b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/199021104?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,777,781,3537,27905,27906,45976,64364,64366,64368,72218</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18674812$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Romundstad, Liv Bente, Dr</creatorcontrib><creatorcontrib>Romundstad, Pål R, PhD</creatorcontrib><creatorcontrib>Sunde, Arne, Prof</creatorcontrib><creatorcontrib>von Düring, Vidar, MD</creatorcontrib><creatorcontrib>Skjærven, Rolv, Prof</creatorcontrib><creatorcontrib>Gunnell, David, Prof</creatorcontrib><creatorcontrib>Vatten, Lars J, Prof</creatorcontrib><title>Effects of technology or maternal factors on perinatal outcome after assisted fertilisation: a population-based cohort study</title><title>The Lancet (British edition)</title><addtitle>Lancet</addtitle><description>Summary Background Research suggests that singleton births following assisted fertilisation are associated with adverse outcomes; however, these results might be confounded by factors that affect both fertility and pregnancy outcome. We therefore compared pregnancy outcomes in women who had singleton pregnancies conceived both spontaneously and after assisted fertilisation. Methods In a population-based cohort study, we assessed differences in birthweight, gestational age, and odds ratios (OR) of small for gestational age babies, premature births, and perinatal deaths in singletons (gestation ≥22 weeks or birthweigh ≥500 g) born to 2546 Norwegian women (>20 years) who had conceived at least one child spontaneously and another after assisted fertilisation among 1 200 922 births after spontaneous conception and 8229 after assisted fertilisation. Findings In the whole study population, assisted-fertilisation conceptions were associated with lower mean birthweight (difference 25 g, 95% CI 14 to 35), shorter duration of gestation (2·0 days, 1·6 to 2·3) and increased risks of small for gestational age (OR 1·26, 1·10 to 1·44), and perinatal death (1·31, 1·05 to 1·65) than were spontaneous conceptions. In the sibling-relationship comparisons, the spontaneous versus the assisted-fertilisation conceptions showed a difference of only 9 g (−18 to 36) in birthweight and 0·6 days (−0·5 to 1·7) in gestational age. For assisted fertilisation versus spontaneous conception in the sibling-relationship comparisons, the OR for small for gestational age was 0·99 (0·62 to 1·57) and that for perinatal mortality was 0·36 (0·20 to 0·67). Interpretation Birthweight, gestational age, and risks of small for gestational age babies, and preterm delivery did not differ among infants of women who had conceived both spontaneously and after assisted fertilisation. The adverse outcomes of assisted fertilisation that we noted compared with those in the general population could therefore be attributable to the factors leading to infertility, rather than to factors related to the reproductive technology. 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Academic</collection><jtitle>The Lancet (British edition)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Romundstad, Liv Bente, Dr</au><au>Romundstad, Pål R, PhD</au><au>Sunde, Arne, Prof</au><au>von Düring, Vidar, MD</au><au>Skjærven, Rolv, Prof</au><au>Gunnell, David, Prof</au><au>Vatten, Lars J, Prof</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effects of technology or maternal factors on perinatal outcome after assisted fertilisation: a population-based cohort study</atitle><jtitle>The Lancet (British edition)</jtitle><addtitle>Lancet</addtitle><date>2008-08-30</date><risdate>2008</risdate><volume>372</volume><issue>9640</issue><spage>737</spage><epage>743</epage><pages>737-743</pages><issn>0140-6736</issn><eissn>1474-547X</eissn><coden>LANCAO</coden><abstract>Summary Background Research suggests that singleton births following assisted fertilisation are associated with adverse outcomes; however, these results might be confounded by factors that affect both fertility and pregnancy outcome. We therefore compared pregnancy outcomes in women who had singleton pregnancies conceived both spontaneously and after assisted fertilisation. Methods In a population-based cohort study, we assessed differences in birthweight, gestational age, and odds ratios (OR) of small for gestational age babies, premature births, and perinatal deaths in singletons (gestation ≥22 weeks or birthweigh ≥500 g) born to 2546 Norwegian women (>20 years) who had conceived at least one child spontaneously and another after assisted fertilisation among 1 200 922 births after spontaneous conception and 8229 after assisted fertilisation. Findings In the whole study population, assisted-fertilisation conceptions were associated with lower mean birthweight (difference 25 g, 95% CI 14 to 35), shorter duration of gestation (2·0 days, 1·6 to 2·3) and increased risks of small for gestational age (OR 1·26, 1·10 to 1·44), and perinatal death (1·31, 1·05 to 1·65) than were spontaneous conceptions. In the sibling-relationship comparisons, the spontaneous versus the assisted-fertilisation conceptions showed a difference of only 9 g (−18 to 36) in birthweight and 0·6 days (−0·5 to 1·7) in gestational age. For assisted fertilisation versus spontaneous conception in the sibling-relationship comparisons, the OR for small for gestational age was 0·99 (0·62 to 1·57) and that for perinatal mortality was 0·36 (0·20 to 0·67). Interpretation Birthweight, gestational age, and risks of small for gestational age babies, and preterm delivery did not differ among infants of women who had conceived both spontaneously and after assisted fertilisation. The adverse outcomes of assisted fertilisation that we noted compared with those in the general population could therefore be attributable to the factors leading to infertility, rather than to factors related to the reproductive technology. Funding St Olavs University Hospital, Trondheim, Norway, and the Norwegian Research Council.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>18674812</pmid><doi>10.1016/S0140-6736(08)61041-7</doi><tpages>7</tpages></addata></record> |
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| subjects | Adult Birth Weight Cohort Studies Embryos Female Fertility Gestational Age Humans Industrialized nations Infertility Internal Medicine Linear Models Maternal Welfare Norway Parity Population Pregnancy Pregnancy Outcome Registries Reproductive Techniques, Assisted - adverse effects Reproductive technologies Studies Technology |
| title | Effects of technology or maternal factors on perinatal outcome after assisted fertilisation: a population-based cohort study |
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