TY - JOUR
T1 - The effect of fertility treatment on adverse perinatal outcomes in women aged at least 40 years
AU - Harlev, Avi
AU - Walfisch, Asnat
AU - Oran, Eynan
AU - Har-Vardi, Iris
AU - Friger, Michael
AU - Lunenfeld, Eitan
AU - Levitas, Eliahu
N1 - Publisher Copyright:
© 2017 International Federation of Gynecology and Obstetrics
PY - 2018/1
Y1 - 2018/1
N2 - Objective: To compare perinatal outcomes between spontaneous conception and assisted reproductive technologies (ART) among patients of advanced maternal age. Methods: The present retrospective study included data from singleton pregnancies of women aged at least 40 years who delivered between January 1, 1991, and December 31, 2013, at Soroka University Medical Center, Beer Sheva, Israel. Demographic, obstetric, and perinatal data were compared between pregnancies conceived with ART (in vitro fertilization [IVF] or ovulation induction) and those conceived spontaneously. Multiple regression models were used to define independent predictors of adverse outcomes. Results: A total of 8244 singleton pregnancies were included; 229 (2.8%) following IVF, 86 (1.0%) following ovulation induction, and 7929 (96.2%) were spontaneous. Preterm delivery (P<0.001), fetal growth restriction (FGR) (P<0.001), and cesarean delivery (P<0.001) demonstrated linear associations with the conception mode; the highest rates for each were observed for IVF, with decreased rates for ovulation induction and spontaneous conception. The incidence of gestational diabetes and hypertensive disorders were highest among pregnancies following ART. No association was observed between conception mode and perinatal mortality. Multivariate logistic regression demonstrated that IVF was independently associated with increased odds of preterm delivery (P<0.001) and FGR (P=0.027) compared with spontaneous conception. Conclusions: Among patients of advanced maternal age, ART were independently associated with increased FGR and preterm delivery rates compared with spontaneous pregnancies; perinatal mortality was comparable.
AB - Objective: To compare perinatal outcomes between spontaneous conception and assisted reproductive technologies (ART) among patients of advanced maternal age. Methods: The present retrospective study included data from singleton pregnancies of women aged at least 40 years who delivered between January 1, 1991, and December 31, 2013, at Soroka University Medical Center, Beer Sheva, Israel. Demographic, obstetric, and perinatal data were compared between pregnancies conceived with ART (in vitro fertilization [IVF] or ovulation induction) and those conceived spontaneously. Multiple regression models were used to define independent predictors of adverse outcomes. Results: A total of 8244 singleton pregnancies were included; 229 (2.8%) following IVF, 86 (1.0%) following ovulation induction, and 7929 (96.2%) were spontaneous. Preterm delivery (P<0.001), fetal growth restriction (FGR) (P<0.001), and cesarean delivery (P<0.001) demonstrated linear associations with the conception mode; the highest rates for each were observed for IVF, with decreased rates for ovulation induction and spontaneous conception. The incidence of gestational diabetes and hypertensive disorders were highest among pregnancies following ART. No association was observed between conception mode and perinatal mortality. Multivariate logistic regression demonstrated that IVF was independently associated with increased odds of preterm delivery (P<0.001) and FGR (P=0.027) compared with spontaneous conception. Conclusions: Among patients of advanced maternal age, ART were independently associated with increased FGR and preterm delivery rates compared with spontaneous pregnancies; perinatal mortality was comparable.
KW - Advanced maternal age
KW - Assisted reproductive technology
KW - In-vitro fertilization
KW - Ovarian aging
KW - Ovulation induction
KW - Perinatal outcome
UR - http://www.scopus.com/inward/record.url?scp=85032828877&partnerID=8YFLogxK
U2 - 10.1002/ijgo.12345
DO - 10.1002/ijgo.12345
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C2 - 28994115
AN - SCOPUS:85032828877
SN - 0020-7292
VL - 140
SP - 98
EP - 104
JO - International Journal of Gynecology and Obstetrics
JF - International Journal of Gynecology and Obstetrics
IS - 1
ER -