Obstetric outcome in women with subfertility.
BACKGROUND
It has been suggested that a history of subfertility is associated with increased obstetric and perinatal risks. It is unclear if the cause is inherent characteristics in the women or the fertility treatment.


OBJECTIVE
To compare the obstetric and perinatal risks of singleton pregnancies in women with a history of subfertility in comparison with the general population.


METHODS
Population cohort.


METHODS
Aberdeen, Scotland.


METHODS
Cases were women attending the Fertility Clinic between 1989 and 1999 who subsequently went on to have singleton pregnancies. Controls included the general population of women who delivered singletons over the same period.


METHODS
We performed a retrospective cohort study to investigate the obstetric outcome of singleton pregnancies in women with subfertility. The general population of women who delivered singletons over the same period served as controls.


METHODS
Obstetric and perinatal complications in singleton pregnancies.


RESULTS
Maternity records were available for a total of 1437 subfertile women and 21,688 controls. Subfertile women were older [mean (SD) age: 31 (4.7) years vs 27 (5.4) years, P < 0.01] and more likely to be primiparous (70% vs 65%, P < 0.001). After adjusting for age and parity, subfertile women were at increased risk of pre-eclampsia (OR 1.9, 95% CI 1.5-2.5), placenta praevia (OR 3.9, 95% CI 2.2-7.0) and placental abruption (OR 1.8, 95% CI 1.1-3.0), and more likely to undergo induction of labour (OR 1.5, 95% CI 1.3-1.6), caesarean section (OR 2.1, 95% CI 1.8-2.4) and instrumental delivery (OR 2.2, 95% CI 1.8-2.6), and deliver low birthweight (OR 1.4, 95% CI 1.3-1.7) and preterm (OR 1.7, 95% CI 1.2-2.2) infants. There were no differences between treatment-related and treatment-independent pregnancies.


CONCLUSIONS
Subfertile women are at higher risk of obstetric complications, which persist after adjusting for age and parity.
Thomson
Fiona
F
Department of Obstetrics and Gynaecology, University of Aberdeen, Aberdeen Maternity Hospital, Foresterhill, Aberdeen AB25 2ZD, Scotland, UK.
Shanbhag
Smrutha
S
Templeton
Allan
A
Bhattacharya
Siladitya
S
D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000453:epidemiology* / Q000628:therapy; D016017:Odds Ratio; D010298:Parity; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D027724:Reproductive Techniques, Assisted / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012606:Scotland / Q000453:epidemiology