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Outcomes of pulmonary vascular disease in infants conceived with non‐IVF fertility treatment and assisted reproductive technologies at 1 year of age
Author(s) -
Fineman David C.,
Baer Rebecca J.,
Chambers Christina D.,
Rajagopal Satish,
Maltepe Emin,
Rinaudo Paolo F.,
Fineman Jeffrey R.,
JelliffePawlowski Laura L.,
Steurer Martina A.
Publication year - 2019
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.24457
Subject(s) - medicine , odds ratio , confidence interval , gestational age , pregnancy , assisted reproductive technology , gestation , reproductive technology , infertility , obstetrics , fertility , birth weight , pediatrics , population , genetics , environmental health , lactation , biology
Background Assisted reproductive technologies (ARTs) have been associated with the development of endothelial dysfunction. Objective To determine potential differences in outcomes associated with pulmonary vascular disease in infants born to mothers receiving any infertility treatment including ART and non‐IVF fertility treatments (NIFTs). Design/Methods The sample was derived from an administrative database containing detailed information on infant and maternal characteristics for live‐born infants in California (2007‐2012) with gestational age (GA) 22 to 44 weeks. Cases were defined as infants with ICD‐9 code for pulmonary vascular disease (PVD) and records for ART/NIFT. Controls were randomly selected at a 1:4 ratio. The primary outcome was 1‐year mortality. Crude and adjusted odds ratio (OR) with 95% confidence interval (CI) were calculated. Results We identified 159 cases and 636 controls. Mothers that utilized ART/NIFT were older, to be of the Caucasian race, to have pre‐eclampsia, private insurance, and education >12 years ( P < .001). Cases compared to controls were more premature, had lower birth weights, and were more often the product of a multiple gestation pregnancy ( P < .001). Cases had a higher 1‐year mortality (18.2% vs 9.1%; OR: 2.2; 95% CI: 1.4, 3.6), more severe PVD (86.2% vs 72.3%; OR: 2.4; 95% CI: 1.5, 3.9), and a longer hospital stay (66.7 ± 73.0 vs 32.5 ± 47.2 days; P < .001) than controls. However, when adjusting for GA these differences become statistically insignificant. Conclusion Children born following ART/NIFT with PVD had increased mortality compared to infants with PVD but without ART/NIFT. The primary driver of this relationship is prematurity.