Adverse obstetric and perinatal outcomes in subfertile women conceiving without assisted reproductive technologies.
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.
Jaques
Alice M
AM
Murdoch Childrens Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia.
Amor
David J
DJ
Baker
H W Gordon
HW
Healy
David L
DL
Ukoumunne
Obioha C
OC
Breheny
Sue
S
Garrett
Claire
C
Halliday
Jane L
JL
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