Please use this identifier to cite or link to this item:
https://hdl.handle.net/2440/94818
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Type: | Journal article |
Title: | Perinatal outcomes by mode of assisted conception and sub-fertility in an Australian data linkage cohort |
Author: | Marino, J. Moore, V. Willson, K. Rumbold, A. Whitrow, M. Giles, L. Davies, M. |
Citation: | PLoS One, 2014; 9(1):e80398-1-e80398-10 |
Publisher: | Public Library of Science |
Issue Date: | 2014 |
ISSN: | 1932-6203 1932-6203 |
Editor: | Lambalk, C. |
Statement of Responsibility: | Jennifer L. Marino, Vivienne M. Moore, Kristyn J. Willson, Alice Rumbold, Melissa J. Whitrow, Lynne C. Giles, Michael J. Davies |
Abstract: | BACKGROUND: Fertility treatment is associated with increased risk of major birth defects, which varies between in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI), and is significantly reduced by embryo freezing. We therefore examined a range of additional perinatal outcomes for these exposures. METHODS: All patients in South Australia receiving assisted conception between Jan 1986-Dec 2002 were linked to the state-wide perinatal collection (all births/stillbirths ≥20 weeks gestation or 400 g birth weight, n = 306 995). We examined stillbirth, mean birth weight, low birth weight (<2500 g, <1500 g), small size for gestational age (<10th percentile, <3rd percentile), large size for gestational age (>90th percentile), preterm birth (32-<37 weeks, <32 weeks gestation), postterm birth (≥41 weeks gestation), Apgar <7 at 5 minutes and neonatal death. RESULTS: Relative to spontaneous conceptions, singletons from assisted conception were more likely to be stillborn (OR = 1.82, 95% Confidence Interval (CI) 1.34-2.48), while survivors as a group were comprehensively disadvantaged at birth, including lower birth weight (-109 g, CI -129--89), very low birth weight (OR = 2.74, CI 2.19-3.43), very preterm birth (OR = 2.30, CI 1.82-2.90) and neonatal death (OR = 2.04, CI 1.27-3.26). Outcomes varied by type of assisted conception. Very low and low birth weight, very preterm and preterm birth, and neonatal death were markedly more common in singleton births from IVF and to a lesser degree, in births from ICSI. Using frozen-embryos eliminated all significant adverse outcomes associated with ICSI but not with IVF. However, frozen-embryo cycles were also associated with increased risk of macrosomia for IVF and ICSI singletons (OR = 1.36, CI 1.02-1.82; OR = 1.55, CI 1.05-2.28). Infertility status without treatment was also associated with adverse outcomes. CONCLUSIONS: Births after assisted conception show an extensive range of compromised outcomes that vary by treatment modality, that are substantially reduced after embryo freezing, but which co-occur with an increased risk of macrosomia. |
Keywords: | Humans Infertility, Female Pregnancy Outcome Reproductive Techniques, Assisted Fertilization in Vitro Data Collection Pregnancy Twins Adult Australia Female Male Stillbirth Live Birth Young Adult |
Rights: | © 2014 Marino et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
DOI: | 10.1371/journal.pone.0080398 |
Grant ID: | http://purl.org/au-research/grants/nhmrc/349475 http://purl.org/au-research/grants/nhmrc/349548 http://purl.org/au-research/grants/nhmrc/453556 http://purl.org/au-research/grants/nhmrc/465455 http://purl.org/au-research/grants/arc/FT100101018 |
Published version: | http://dx.doi.org/10.1371/journal.pone.0080398 |
Appears in Collections: | Aurora harvest 7 Public Health publications |
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hdl_94818.pdf | Published version | 287.77 kB | Adobe PDF | View/Open |
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