title: The course of pregnancy and delivery and the use of maternal healthcare services after standard IVF in Northern Finland 1990-1995.
abstract: BACKGROUND
  The objective of this study was to evaluate the course of pregnancy and delivery and the use of maternal healthcare after IVF.
  
  
  METHODS
  This population-based cohort study included all women who had undergone IVF treatment in Northern Finland leading to delivery in 1990-1995 (n = 225) and control pregnancies derived from the Finnish Medical Birth Register (n = 671) matched for sex of the child, year of birth, area, maternal age, parity, social class and fetal plurality. The analyses were stratified by plurality. Outcome measures were pregnancy complications, mode of delivery, gestational length and the level of use of antenatal care.
  
  
  RESULTS
  The results showed an increased risk for vaginal bleeding throughout pregnancy [relative risk (RR) 4.1, 95% confidence interval (CI) 2.5-6.7 for singletons; RR 6.9, 95% CI 2.5-19.2 for twins], threatened preterm birth (RR 1.8, 95% CI 1.1-2.9, singletons) and intrahepatic cholestasis of pregnancy (RR 3.8, 95% CI 1.0-15.0, singletons) in IVF pregnancies, as well as an increase in the use of specialized antenatal care.
  
  
  CONCLUSIONS
  IVF pregnancies following standard, fresh ova IVF treatments are at greater risk of obstetric problems than spontaneously conceived pregnancies, and hence IVF mothers use more specialized antenatal care than others. The pregnancy complications after IVF are likely to be due to maternal characteristics regarding infertility and to a high incidence of multiple pregnancies.
authors.affiliation: Department of Public Health Science and General Practice, University of Oulu, P O Box 5000, 90014 Oulu, Finland. sari.koivurova@oulu.fi
authors.forename: Sari
authors.initials: S
authors.lastname: Koivurova
authors.forename: Anna-Liisa
authors.initials: AL
authors.lastname: Hartikainen
authors.forename: Liisa
authors.initials: L
authors.lastname: Karinen
authors.forename: Mika
authors.initials: M
authors.lastname: Gissler
authors.forename: Elina
authors.initials: E
authors.lastname: Hemminki
authors.forename: Hannu
authors.initials: H
authors.lastname: Martikainen
authors.forename: Leena
authors.initials: L
authors.lastname: Tuomivaara
authors.forename: Marjo-Riitta
authors.initials: MR
authors.lastname: Järvelin
mesh_terms: D000328:Adult; D002779:Cholestasis / Q000209:etiology; D015331:Cohort Studies; D036861:Delivery, Obstetric; D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects; D005387:Finland; D006801:Humans; D008427:Maternal Health Services / Q000706:statistics & numerical data*; D008511:Medicine; D007752:Obstetric Labor, Premature / Q000209:etiology; D011247:Pregnancy / Q000502:physiology*; D011248:Pregnancy Complications / Q000209:etiology; D011249:Pregnancy Complications, Cardiovascular / Q000209:etiology; D011256:Pregnancy Outcome; D011295:Prenatal Care / Q000706:statistics & numerical data; D012307:Risk Factors; D013038:Specialization; D014592:Uterine Hemorrhage / Q000209:etiology