title: Perinatal outcomes associated with assisted reproductive technology: the Massachusetts Outcomes Study of Assisted Reproductive Technologies (MOSART).
abstract: OBJECTIVE
  To compare on a population basis the birth outcomes of women treated with assisted reproductive technologies (ART), women with indicators of subfertility but without ART, and fertile women.
  
  
  METHODS
  Longitudinal cohort study.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  A total of 334,628 births and fetal deaths to Massachusetts mothers giving birth in a Massachusetts hospital from July 1, 2004, to December 31, 2008, subdivided into three subgroups for comparison: ART 11,271, subfertile 6,609, and fertile 316,748.
  
  
  METHODS
  None.
  
  
  METHODS
  Four outcomes-preterm birth, low birth weight, small for gestational age, and perinatal death-were modeled separately for singletons and twins with the use of logistic regression for the primary comparison between ART births and those to the newly created population-based subgroup of births to women with indicators of subfertility but no ART.
  
  
  RESULTS
  For singletons, the risks for both preterm birth and low birth weight were higher for the ART group (adjusted odds ratios [AORs] 1.23 and 1.26, respectively) compared with the subfertile group, and risks in both the ART and the subfertile groups were higher than those among the fertile births group. For twins, the risk of perinatal death was significantly lower among ART births than fertile (AOR 0.55) or subfertile (AOR 0.15) births.
  
  
  CONCLUSIONS
  The use of a population-based comparison group of subfertile births without ART demonstrated significantly higher rates of preterm birth and low birth weight in ART singleton births, but these differences are smaller than differences between ART and fertile births. Further refinement of the measurement of subfertile births and examination of the independent risks of subfertile births is warranted.
authors: Boston University School of Public Health, Boston, Massachusetts. Electronic address: declercq@bu.edu.
authors: Eugene
authors: E
authors: Declercq
authors: Michigan State University, East Lansing, Michigan.
authors: Barbara
authors: B
authors: Luke
authors: Boston University School of Public Health, Boston, Massachusetts.
authors: Candice
authors: C
authors: Belanoff
authors: Boston University School of Public Health, Boston, Massachusetts.
authors: Howard
authors: H
authors: Cabral
authors: Massachusetts Department of Public Health, Boston, Massachusetts.
authors: Hafsatou
authors: H
authors: Diop
authors: Boston University School of Public Health, Boston, Massachusetts.
authors: Daksha
authors: D
authors: Gopal
authors: Boston University School of Public Health, Boston, Massachusetts.
authors: Lan
authors: L
authors: Hoang
authors: Mass General Hospital for Children, Harvard Medical School, Boston, Massachusetts.
authors: Milton
authors: M
authors: Kotelchuck
authors: Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
authors: Judy E
authors: JE
authors: Stern
authors: Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
authors: Mark D
authors: MD
authors: Hornstein
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D007246:Infertility / Q000453:epidemiology / Q000628:therapy; D008137:Longitudinal Studies; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D018873:Pregnancy Rate; D047928:Premature Birth / Q000453:epidemiology; D027724:Reproductive Techniques, Assisted / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Assisted reproductive technologies; low birth weight; perinatal death; preterm birth; subfertility