title: Adverse obstetric and perinatal outcomes in subfertile women conceiving without assisted reproductive technologies.
abstract: OBJECTIVE
  To determine whether adverse perinatal outcomes are increased in subfertile women.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  Two tertiary assisted reproductive technologies (ART) centers; Victorian births register.
  
  
  METHODS
  Records of women who registered with the clinics (1991-2000), but did not have an infant using ART, were linked to the birth register (1991-2004) to identify singleton non-ART births within 5 years of registration (N = 2171). Controls, matched by maternal age and year of infant's birth, were selected randomly from birth records (N = 4363).
  
  
  METHODS
  None.
  
  
  METHODS
  Adverse obstetric and perinatal outcomes.
  
  
  RESULTS
  After adjusting for confounders, compared with controls, subfertile women had increased odds of hypertension or preeclampsia (adjusted odds ratio [OR] 1.29, 1.02-1.61), antepartum hemorrhage (adjusted OR 1.41, 1.05-1.89), perinatal death (adjusted OR 2.19, 1.10-4.36), low birth weight (adjusted OR 1.44, 1.11-1.85), preterm birth <37 weeks (adjusted OR 1.32, 1.05-1.67) or <31 weeks (adjusted OR 2.37, 1.35-4.13), and cesarean delivery (adjusted OR 1.56, 1.37-1.77). There was weak evidence for increased birth defects (adjusted OR 1.30, 0.98-1.72) and gestational diabetes (adjusted OR 1.25, 0.96-1.63). No increased risk was found for prelabor rupture of membranes, small for gestational age, or postpartum hemorrhage.
  
  
  CONCLUSIONS
  Subfertile women with singleton births are at increased risk of several adverse outcomes. These risks should be considered during their antenatal care and when analyzing adverse effects of ART.
authors.affiliation: Murdoch Childrens Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia.
authors.forename: Alice M
authors.initials: AM
authors.lastname: Jaques
authors.forename: David J
authors.initials: DJ
authors.lastname: Amor
authors.forename: H W Gordon
authors.initials: HW
authors.lastname: Baker
authors.forename: David L
authors.initials: DL
authors.lastname: Healy
authors.forename: Obioha C
authors.initials: OC
authors.lastname: Ukoumunne
authors.forename: Sue
authors.initials: S
authors.lastname: Breheny
authors.forename: Claire
authors.initials: C
authors.lastname: Garrett
authors.forename: Jane L
authors.initials: JL
authors.lastname: Halliday
mesh_terms: D000328:Adult; D000465:Algorithms; D016022:Case-Control Studies; D005260:Female; D005298:Fertility / Q000502:physiology; D005306:Fertilization / Q000502:physiology; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology; D007247:Infertility, Female / Q000453:epidemiology*; D050498:Live Birth / Q000453:epidemiology; D015337:Multicenter Studies as Topic; D007744:Obstetric Labor Complications / Q000453:epidemiology*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012042:Registries; D027724:Reproductive Techniques, Assisted / Q000009:adverse effects / Q000706:statistics & numerical data