In-vitro fertilisation and neonatal ventilator use in a tertiary perinatal centre.
OBJECTIVE
To determine the contribution of livebirths resulting from in-vitro fertilisation and related technologies (IVF) to the use of neonatal ventilator beds.


METHODS
A retrospective review of records of all livebirths from our hospital's IVF program and all IVF infants receiving mechanical ventilation in our neonatal intensive care unit for the period 1985-1989. We also reviewed records of labour ward deliveries, neonatal intensive care unit admissions and transfer requests in order to obtain comparative data for livebirths of non-IVF infants whose mothers had been booked to deliver in our hospital.


METHODS
A tertiary perinatal centre with a large IVF program and a Level 3 neonatal intensive care unit.


RESULTS
IVF livebirths accounted for 5.1% of total ventilator bed days. Compared with non-IVF booked livebirths, IVF babies were more likely to require ventilation (odds ratio, 7.41; P less than 0.0001) and used more ventilator bed days per 100 livebirths (rate ratio, 9.63; P less than 0.0001), largely due to preterm delivery of multiple pregnancies; 42.3% of IVF babies who required ventilation were from triplet births and 38.5% from twin births. Nevertheless, even IVF singletons used more ventilator bed days per 100 livebirths than non-IVF booked livebirths (rate ratio, 2.78; P less than 0.0001). IVF livebirths accounted for 9.9% of the 78% increase in ventilator bed days used in 1989 compared with 1985.


CONCLUSIONS
IVF livebirths accounted for only a small percentage of the overall use of neonatal ventilator beds, but consumed relatively more of such resources per livebirth than did non-IVF livebirths. The degree of risk of requiring ventilation is directly related to the number of infants in a multiple pregnancy, but even IVF singletons are at a relatively high risk of requiring ventilation.
Leslie
G I
GI
Department of Neonatology, Royal North Shore Hospital, St Leonards, NSW.
Bowen
J R
JR
Arnold
J D
JD
Saunders
D M
DM
D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data*; D009517:New South Wales / Q000453:epidemiology; D007752:Obstetric Labor, Premature; D011247:Pregnancy; D011272:Pregnancy, Multiple; D012121:Respiration, Artificial / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012306:Risk; D014310:Triplets; D014427:Twins