title: Effect of maternal age on maternal and neonatal outcomes after assisted reproductive technology.
abstract: OBJECTIVE
  To compare the effect of maternal age on assisted reproductive technology (ART) and spontaneous conception (SC) pregnancies regarding maternal and neonatal complications.
  
  
  METHODS
  Nordic retrospective population-based cohort study. Data from national ART registries were cross-linked with national medical birth registries.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  A total of 300,085 singleton deliveries: 39,919 after ART and 260,166 after SC.
  
  
  METHODS
  None.
  
  
  METHODS
  Hypertensive disorders in pregnancy (HDP), placenta previa, cesarean delivery, preterm birth (PTB; <37 weeks), low birth weight (LBW; <2,500 g), small for gestational age (SGA), and perinatal mortality (≥28 weeks). Adjusted odds ratios (AORs) were calculated. Associations between maternal age and outcomes were analyzed.
  
  
  RESULTS
  The risk of placenta previa (AOR 4.11-6.05), cesarean delivery (AOR 1.18-1.50), PTB (AOR 1.23-2.19), and LBW (AOR 1.44-2.35) was significantly higher in ART than in SC pregnancies for most maternal ages. In both ART and SC pregnancies, the risk of HDP, placenta previa, cesarean delivery, PTB, LBW, and SGA changed significantly with age. The AORs for adverse neonatal outcomes at advanced maternal age (>35 years) showed a greater increase in SC than in ART. The change in risk with age did not differ between ART and SC for maternal outcomes at advanced maternal age.
  
  
  CONCLUSIONS
  Having singleton conceptions after ART results in higher maternal and neonatal outcome risks overall, but the impact of age seems to be more pronounced in couples conceiving spontaneously.
authors.affiliation: Department of Obstetrics and Gynecology, Institute for Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; Nordic IVF Center Göteborg, Gothenburg, Sweden. Electronic address: annalena.wennberg@gbgkk.se.
authors.forename: Anna Lena
authors.initials: AL
authors.lastname: Wennberg
authors.affiliation: Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway; Central Norway Regional Health Authority, Stjørdal, Norway.
authors.forename: Signe
authors.initials: S
authors.lastname: Opdahl
authors.affiliation: Department of Obstetrics and Gynecology, Institute for Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
authors.forename: Christina
authors.initials: C
authors.lastname: Bergh
authors.affiliation: Fertility Clinic, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
authors.forename: Anna-Karina
authors.initials: AK
authors.lastname: Aaris Henningsen
authors.affiliation: National Institute of Health and Welfare, Helsinki, Finland.
authors.forename: Mika
authors.initials: M
authors.lastname: Gissler
authors.affiliation: Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway; Central Norway Regional Health Authority, Stjørdal, Norway; Spiren Fertility Clinic, Trondheim, Norway.
authors.forename: Liv Bente
authors.initials: LB
authors.lastname: Romundstad
authors.affiliation: Department of Obstetrics and Gynecology, Hvidovre Hospital, Institute of Clinical Medicine, Copenhagen University Hospital, Copenhagen, Denmark.
authors.forename: Anja
authors.initials: A
authors.lastname: Pinborg
authors.affiliation: Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Aila
authors.initials: A
authors.lastname: Tiitinen
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; Medical Birth Registry of Norway, National Institute of Public Health, Bergen, Norway.
authors.forename: Rolv
authors.initials: R
authors.lastname: Skjærven
authors.affiliation: Department of Obstetrics and Gynecology, Institute for Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
authors.forename: Ulla-Britt
authors.initials: UB
authors.lastname: Wennerholm
mesh_terms: D000328:Adult; D001724:Birth Weight; D002585:Cesarean Section; D005260:Female; D005298:Fertility; D005865:Gestational Age; D006801:Humans; D007230:Infant, Low Birth Weight; D007234:Infant, Premature; D007246:Infertility / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D050498:Live Birth; D016015:Logistic Models; D008423:Maternal Age; D008875:Middle Aged; D016017:Odds Ratio; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology*; D047928:Premature Birth / Q000209:etiology; D012042:Registries; D027724:Reproductive Techniques, Assisted / Q000009:adverse effects*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012537:Scandinavian and Nordic Countries; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: ART; Assisted reproductive technologies; maternal age; maternal complications; neonatal complications; spontaneous conception