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Intrapartum and neonatal outcomes in singleton pregnancies following conception by assisted reproduction techniques
Author(s) -
Rozdarz Kellie M.,
Flatley Christopher J.,
Kumar Sailesh
Publication year - 2017
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/ajo.12620
Subject(s) - medicine , neonatal intensive care unit , obstetrics , odds ratio , respiratory distress , apgar score , retrospective cohort study , pregnancy , spontaneous conception , gestational age , assisted reproductive technology , vaginal delivery , caesarean section , fetal distress , gestation , neonatal resuscitation , birth weight , pediatrics , population , resuscitation , fetus , infertility , emergency medicine , anesthesia , surgery , fertility , environmental health , pathology , biology , genetics
Background To characterise maternal demographics and ascertain whether clinically important differences exist in the intrapartum and neonatal outcomes associated with assisted reproductive technology ( ART ). Materials and 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% CI 0.63–0.81) were lower in the ART cohort. Conclusion Although higher rates of operative deliveries were seen for women who conceive using ART , neonatal outcomes were generally no different between the two cohorts.