Assisted reproductive technology and the risk of preterm birth among primiparas

Galit Levi Dunietz, Claudia Holzman, Patricia McKane, Chenxi Li, Sheree L. Boulet, David Todem, Dmitry M. Kissin, Glenn Copeland, Dana Bernson, William M. Sappenfield, Michael Peter Diamond

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Objective: To investigate the risk of preterm birth among liveborn singletons to primiparas who conceived with assisted reproductive technology (ART) using four mutually exclusive categories of infertility (female infertility only, male infertility only, female and male infertility, and unexplained infertility) and to examine preterm birth risk along the gestational age continuum. Design: Retrospective cohort study. Setting: Not applicable. Patient(s): Singletons born to primiparas who conceived with or without ART. Intervention(s): None. Main Outcome Measure(s): Preterm (<37 weeks' gestation) and preterm/early term birth <39 weeks' gestation). Result(s): For the male infertility only, female infertility only, combined male and female infertility, and unexplained infertility groups, ART-conceived singletons were significantly more likely than non-ART singletons to be born preterm: adjusted odds ratio (aOR) 1.24 (95% CI, 1.13, 1.37), aOR 1.60 (95% CI, 1.50, 1.70), aOR 1.49 (95% CI, 1.35, 1.64), and aOR 1.26 (1.12, 1.43) respectively. Among infants whose mothers were diagnosed with infertility, the odds of preterm birth were highest between 28-30 weeks [female infertility only, aOR 1.95 (95% CI, 1.59, 2.39); male and female infertility: 2.21 (95% CI, 1.62, 3.00)] compared with infants in the general population. Within the ART population, singletons of couples with female infertility only were more likely to be born preterm than singletons born to couples with other infertility diagnoses. Conclusion(s): Among singleton births to primiparas, those conceived with ART had an increased risk for preterm birth, even when only the male partner had been diagnosed with infertility. The risk of preterm birth for ART-conceived infants whose mothers were diagnosed with infertility included the earliest deliveries.

Original languageEnglish (US)
Pages (from-to)974-979.e1
JournalFertility and Sterility
Volume103
Issue number4
DOIs
StatePublished - Jan 1 2015

Fingerprint

Female Infertility
Assisted Reproductive Techniques
Premature Birth
Infertility
Male Infertility
Odds Ratio
Mothers
Term Birth
Reproductive Techniques
Pregnancy
Population
Gestational Age
Cohort Studies
Retrospective Studies
Outcome Assessment (Health Care)
Parturition

Keywords

  • Assisted reproductive technology (ART)
  • Infertility
  • Preterm birth

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

Cite this

Assisted reproductive technology and the risk of preterm birth among primiparas. / Dunietz, Galit Levi; Holzman, Claudia; McKane, Patricia; Li, Chenxi; Boulet, Sheree L.; Todem, David; Kissin, Dmitry M.; Copeland, Glenn; Bernson, Dana; Sappenfield, William M.; Diamond, Michael Peter.

In: Fertility and Sterility, Vol. 103, No. 4, 01.01.2015, p. 974-979.e1.

Research output: Contribution to journalArticle

Dunietz, GL, Holzman, C, McKane, P, Li, C, Boulet, SL, Todem, D, Kissin, DM, Copeland, G, Bernson, D, Sappenfield, WM & Diamond, MP 2015, 'Assisted reproductive technology and the risk of preterm birth among primiparas', Fertility and Sterility, vol. 103, no. 4, pp. 974-979.e1. https://doi.org/10.1016/j.fertnstert.2015.01.015
Dunietz, Galit Levi ; Holzman, Claudia ; McKane, Patricia ; Li, Chenxi ; Boulet, Sheree L. ; Todem, David ; Kissin, Dmitry M. ; Copeland, Glenn ; Bernson, Dana ; Sappenfield, William M. ; Diamond, Michael Peter. / Assisted reproductive technology and the risk of preterm birth among primiparas. In: Fertility and Sterility. 2015 ; Vol. 103, No. 4. pp. 974-979.e1.
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abstract = "Objective: To investigate the risk of preterm birth among liveborn singletons to primiparas who conceived with assisted reproductive technology (ART) using four mutually exclusive categories of infertility (female infertility only, male infertility only, female and male infertility, and unexplained infertility) and to examine preterm birth risk along the gestational age continuum. Design: Retrospective cohort study. Setting: Not applicable. Patient(s): Singletons born to primiparas who conceived with or without ART. Intervention(s): None. Main Outcome Measure(s): Preterm (<37 weeks' gestation) and preterm/early term birth <39 weeks' gestation). Result(s): For the male infertility only, female infertility only, combined male and female infertility, and unexplained infertility groups, ART-conceived singletons were significantly more likely than non-ART singletons to be born preterm: adjusted odds ratio (aOR) 1.24 (95{\%} CI, 1.13, 1.37), aOR 1.60 (95{\%} CI, 1.50, 1.70), aOR 1.49 (95{\%} CI, 1.35, 1.64), and aOR 1.26 (1.12, 1.43) respectively. Among infants whose mothers were diagnosed with infertility, the odds of preterm birth were highest between 28-30 weeks [female infertility only, aOR 1.95 (95{\%} CI, 1.59, 2.39); male and female infertility: 2.21 (95{\%} CI, 1.62, 3.00)] compared with infants in the general population. Within the ART population, singletons of couples with female infertility only were more likely to be born preterm than singletons born to couples with other infertility diagnoses. Conclusion(s): Among singleton births to primiparas, those conceived with ART had an increased risk for preterm birth, even when only the male partner had been diagnosed with infertility. The risk of preterm birth for ART-conceived infants whose mothers were diagnosed with infertility included the earliest deliveries.",
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AU - Todem, David

AU - Kissin, Dmitry M.

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