title: Perinatal outcome of ICSI pregnancies compared with a matched group of natural conception pregnancies in Flanders (Belgium): a cohort study.
abstract: A retrospective cohort study was conducted with an intracytoplasmic sperm injection (ICSI) group and a naturally conceived comparison group. A total of 1655 singleton and 1102 twin ICSI births were studied with regard to perinatal outcome. Control subjects (naturally conceived pregnancies) were selected from a regional registry and were matched for maternal age, parity, place of delivery, year of birth and fetal sex. The main outcome measures were duration of pregnancy, birth weight, Apgar score <5 after 5 min, neonatal complications, perinatal death and congenital malformations. Twin births, when compared with singletons, carry a much higher risk of poor perinatal outcome. For both ICSI singletons and ICSI twins, no significant difference was found between ICSI and naturally conceived pregnancies for all investigated parameters. After excluding like-sex twin pairs, ICSI twin pregnancies were at increased risk for perinatal mortality (OR = 2.74, CI = 1.26-5.98), prematurity (OR = 1.38, CI = 1.10-1.75) and low birth weight (OR = 1.34, CI = 1.06-1.69) compared with spontaneously conceived different-sex twin pairs. In conclusion, the perinatal outcome of ICSI singleton and twin pregnancies was very similar to that of spontaneously conceived pregnancies in this large cohort study. After excluding like-sex twin pairs, ICSI twins were at increased risk for prematurity, low birth weight and higher perinatal mortality compared with the natural conception comparison group.
authors.affiliation: Genk Institute for Fertility Technology, Department of Obstetrics and Gynaecology, Genk, Belgium. willem.ombelet@pandora.be
authors.forename: Willem
authors.initials: W
authors.lastname: Ombelet
authors.forename: Karen
authors.initials: K
authors.lastname: Peeraer
authors.forename: Petra
authors.initials: P
authors.lastname: De Sutter
authors.forename: Jan
authors.initials: J
authors.lastname: Gerris
authors.forename: Eugene
authors.initials: E
authors.lastname: Bosmans
authors.forename: Guy
authors.initials: G
authors.lastname: Martens
authors.forename: Gunther
authors.initials: G
authors.lastname: Ruyssinck
authors.forename: Paul
authors.initials: P
authors.lastname: Defoort
authors.forename: Geert
authors.initials: G
authors.lastname: Molenberghs
authors.forename: Wilfried
authors.initials: W
authors.lastname: Gyselaers
mesh_terms: D000328:Adult; D001530:Belgium; D015331:Cohort Studies; D005260:Female; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic