title: Adverse pregnancy and birth outcomes associated with underlying diagnosis with and without assisted reproductive technology treatment.
abstract: OBJECTIVE
  To compare the risks for adverse pregnancy and birth outcomes by diagnoses with and without assisted reproductive technology (ART) treatment to non-ART pregnancies in fertile women.
  
  
  METHODS
  Historical cohort of Massachusetts vital records linked to ART clinic data from Society for Assisted Reproductive Technology Clinic Outcome Reporting System.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Diagnoses included male factor (ART only), endometriosis, ovulation disorders, tubal (ART only), and reproductive inflammatory disorders (non-ART only). Pregnancies resulting in singleton and twin live births from 2004 to 2008 were linked to hospital discharges in women who had ART treatment (n = 3,689), women with no ART treatment in the current pregnancy (n = 4,098), and non-ART pregnancies in fertile women (n = 297,987).
  
  
  METHODS
  None.
  
  
  METHODS
  Risks of gestational diabetes, prenatal hospitalizations, prematurity, low birth weight, and small for gestational age were modeled using multivariate logistic regression with fertile deliveries as the reference group adjusted for maternal age, race/ethnicity, education, chronic hypertension, diabetes mellitus, and plurality (adjusted odds ratios [AORs] and 95% confidence intervals [CIs]).
  
  
  RESULTS
  Risk of prenatal hospital admissions was increased for endometriosis (ART: 1.97, 1.38-2.80; non-ART: 3.34, 2.59-4.31), ovulation disorders (ART: 2.31, 1.81-2.96; non-ART: 2.56, 2.05-3.21), tubal factor (ART: 1.51, 1.14-2.01), and reproductive inflammation (non-ART: 2.79, 2.47-3.15). Gestational diabetes was increased for women with ovulation disorders (ART: 2.17, 1.72-2.73; non-ART: 1.94, 1.52-2.48). Preterm delivery (AORs, 1.24-1.93) and low birth weight (AORs, 1.27-1.60) were increased in all groups except in endometriosis with ART.
  
  
  CONCLUSIONS
  The findings indicate substantial excess perinatal morbidities associated with underlying infertility-related diagnoses in both ART-treated and non-ART-treated women.
authors: Department of Obstetrics and Gynecology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire. Electronic address: judy.e.stern@dartmouth.edu.
authors: Judy E
authors: JE
authors: Stern
authors: Department of Obstetrics, Gynecology, and Reproductive Biology, Michigan State University, East Lansing, Michigan.
authors: Barbara
authors: B
authors: Luke
authors: Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts.
authors: Michael
authors: M
authors: Tobias
authors: Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts.
authors: Daksha
authors: D
authors: Gopal
authors: Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
authors: Mark D
authors: MD
authors: Hornstein
authors: Massachusetts Department of Public Health, Boston, Massachusetts.
authors: Hafsatou
authors: H
authors: Diop
mesh_terms: D017677:Age Distribution; D015331:Cohort Studies; D015897:Comorbidity; D004522:Educational Status; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007246:Infertility / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D008137:Longitudinal Studies; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008423:Maternal Age; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D059285:Pregnancy, Twin / Q000706:statistics & numerical data*; D015995:Prevalence; D027724:Reproductive Techniques, Assisted / Q000706:statistics & numerical data*; D012307:Risk Factors
keywords: ART; endometriosis; low birth weight; ovulatory disorder; pregnancy outcome; preterm delivery