title: Intrapartum and neonatal outcomes in singleton pregnancies following conception by assisted reproduction techniques.
abstract: BACKGROUND
  To characterise maternal demographics and ascertain whether clinically important differences exist in the intrapartum and neonatal outcomes associated with assisted reproductive technology (ART).
  
  
  METHODS
  A retrospective study was undertaken between January 2007 and December 2013 of all singleton pregnancies conceived via ART at a major tertiary unit in Brisbane, Australia. Intrapartum outcomes were mode of delivery and indication for emergency caesarean. Neonatal outcomes investigated were gestation at delivery, birth weight, Apgar scores, acidosis at birth, respiratory distress, need for resuscitation, admission to neonatal intensive care and stillbirth.
  
  
  RESULTS
  There were 4733 (7.4%) ART and 59 277 (92.6%) spontaneous conception pregnancies. Women who conceived using ART were less likely to have a spontaneous vaginal delivery (odds ratio (OR) 0.60, 95% CI 0.57-0.64) and were more likely to require operative or assisted birth: elective caesarean (adjusted OR (aOR) 1.31, 95% CI 1.22-1.40), emergency caesarean (aOR 1.19, 95% CI 1.09-1.28), or instrumental delivery (aOR 1.45, 95% CI 1.32-1.58). Neonates who were conceived using ART were less likely to be born at term (aOR 0.64, 95% CI 0.58-0.71) and have lower birth weights. No differences were observed in rates of respiratory distress, admission to the neonatal intensive care unit, or stillbirth between the ART and spontaneous conception cohorts. The odds of neonatal acidosis (OR 0.71, 95% CI0.63-0.81) were lower in the ART cohort.
  
  
  CONCLUSIONS
  Although higher rates of operative deliveries were seen for women who conceive using ART, neonatal outcomes were generally no different between the two cohorts.
authors.affiliation: Mater Mothers' Hospital, South Brisbane, Queensland, Australia.
authors.forename: Kellie M
authors.initials: KM
authors.lastname: Rozdarz
authors.affiliation: Mater Research Institute - University of Queensland, South Brisbane, Queensland, Australia.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Flatley
authors.affiliation: Mater Mothers' Hospital, South Brisbane, Queensland, Australia.|Mater Research Institute - University of Queensland, South Brisbane, Queensland, Australia.
authors.forename: Sailesh
authors.identifier: http://orcid.org/0000-0003-0832-4811
authors.initials: S
authors.lastname: Kumar
mesh_terms: D000138:Acidosis / Q000453:epidemiology; D000328:Adult; D001034:Apgar Score; D001724:Birth Weight; D002585:Cesarean Section / Q000706:statistics & numerical data*; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D005260:Female; D005306:Fertilization; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D010343:Patient Admission; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology; D027724:Reproductive Techniques, Assisted; D012127:Respiratory Distress Syndrome, Newborn / Q000453:epidemiology; D012151:Resuscitation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D050497:Stillbirth / Q000453:epidemiology; D047929:Term Birth
keywords: assisted reproduction techniques; caesarean section; fetal compromise; intrapartum outcomes; neonatal outcomes