title: Preimplantation genetic diagnosis: a national multicenter obstetric and neonatal follow-up study.
abstract: OBJECTIVE
  To study whether women conceiving after preimplantation genetic diagnosis (PGD) and their children have greater risks of adverse pregnancy and birth outcomes compared with children conceived spontaneously or after IVF with or without intracytoplasmic sperm injection (ICSI).
  
  
  METHODS
  Historical cohort study.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  All deliveries following PGD treatment for single gene and sex-linked disorders or structural chromosomal aberrations (n = 126 deliveries/149 children), IVF/ICSI treatment (n = 30,418 deliveries/36,115 children), and spontaneous conception (n = 896,448 deliveries/909,624 children).
  
  
  METHODS
  None.
  
  
  METHODS
  Adverse obstetric and neonatal outcomes, such as pre-eclampsia, preterm primary rupture of membranes, placenta previa, abruption of placenta, preterm birth, low birth weight, malformations, and neonatal admission.
  
  
  RESULTS
  Compared with spontaneously conceived pregnancies, PGD pregnancies were at significantly increased risk of placenta previa (adjusted odds ratio [ORa] 9.1; 95% confidence interval [95% CI] 3.4, 24.9), cesarean section (ORa 2.0; 95% CI 1.3, 2.9), preterm birth (ORa 1.6; 95% CI 1.0, 2.7), shorter gestation (mean difference -3.4 days; 95% CI -5.7, -1.1 days), and longer neonatal admission (mean difference 21 days; 95% CI 15, 28 days). The risks were comparable to that of pregnancies following IVF/ICSI. In subanalyses, adverse outcomes were only present in children conceived by PGD owing to parental monogenetic disorder and comparable to those of children born to parents with monogenic disorders conceiving without PGD, except for a higher risk of placenta previa.
  
  
  CONCLUSIONS
  In this cohort study, the risk of adverse obstetric and neonatal outcomes was mainly related to the underlying parental condition rather than the PGD procedure.
authors.affiliation: The Fertility Clinic and Center of Preimplantation Genetic Diagnosis, Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark; The Fertility Clinic, Department of Obstetrics and Gynecology, Institute of Clinical Medicine, Aarhus University, Regionshospitalet, Horsens, Denmark. Electronic address: bjornbay@me.com.
authors.forename: Bjorn
authors.initials: B
authors.lastname: Bay
authors.affiliation: The Fertility Clinic and Center of Preimplantation Genetic Diagnosis, Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Hans Jakob
authors.initials: HJ
authors.lastname: Ingerslev
authors.affiliation: The Fertility Clinic, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Josephine Gabriela
authors.initials: JG
authors.lastname: Lemmen
authors.affiliation: The Fertility Clinic and Center of Preimplantation Genetic Diagnosis, Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Birte
authors.initials: B
authors.lastname: Degn
authors.affiliation: The Fertility Clinic, Department of Gynecology and Obstetrics, Odense Universitetshospital, Odense, Denmark.
authors.forename: Iben Anne
authors.initials: IA
authors.lastname: Rasmussen
authors.affiliation: The Fertility Clinic and Center of Preimplantation Genetic Diagnosis, Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark; The Fertility Clinic, Department of Gynecology and Obstetrics, Herlev and Gentofte Hospital, Herlev, Denmark.
authors.forename: Ulrik Schiøler
authors.initials: US
authors.lastname: Kesmodel
mesh_terms: D001706:Biopsy; D003718:Denmark; D005260:Female; D005298:Fertility; D005307:Fertilization in Vitro / Q000009:adverse effects; D030342:Genetic Diseases, Inborn / Q000175:diagnosis* / Q000235:genetics; D005820:Genetic Testing; D006801:Humans; D007246:Infertility / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D016014:Linear Models; D050498:Live Birth; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology; D019836:Preimplantation Diagnosis / Q000009:adverse effects; D012307:Risk Factors; D020554:Sperm Injections, Intracytoplasmic; D016896:Treatment Outcome
keywords: Assisted reproduction; PGD; neonatal outcomes; obstetric outcomes