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In–vitro fertilisation and neonatal ventilator use in a tertiary perinatal centre
Author(s) -
Leslie Garth I,
Bowen Jennifer R,
Arnold John D,
Saunders Douglas M
Publication year - 1992
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1992.tb137078.x
Subject(s) - medicine , neonatal intensive care unit , odds ratio , obstetrics , intensive care , retrospective cohort study , gynecology , pediatrics , surgery , pathology , intensive care medicine
Objective To determine the contribution of livebirths resulting from in‐vitro fertilisation and related technologies (IVF) to the use of neonatal ventilator beds. Design A retrospective review of records of all livebirths from our hospital's IVF program and all IVF infants receiving mechanical ventilation in our neonatal intensive care unit for the period 1985–1989. We also reviewed records of labour ward deliveries, neonatal intensive care unit admissions and transfer requests in order to obtain comparative data for livebirths of non‐IVF infants whose mothers had been booked to deliver in our hospital. Setting A tertiary perinatal centre with a large IVF program and a Level 3 neonatal intensive care unit. Results IVF livebirths accounted for 5.1% of total ventilator bed days. Compared with non‐IVF booked livebirths, IVF babies were more likely to require ventilation (odds ratio, 7.41; P < 0.0001) and used more ventilator bed days per 100 livebirths (rate ratio, 9.63; P < 0.0001), largely due to preterm delivery of multiple pregnancies; 42.3% of IVF babies who required ventilation were from triplet births and 38.5% from twin births. Nevertheless, even IVF singletons used more ventilator bed days per 100 livebirths than non‐IVF booked livebirths (rate ratio, 2.78; P < 0.0001). IVF livebirths accounted for 9.9% of the 78% increase in ventilator bed days used in 1989 compared with 1985. Conclusions IVF livebirths accounted for only a small percentage of the overall use of neonatal ventilator beds, but consumed relatively more of such resources per livebirth than did non‐IVF livebirths. The degree of risk of requiring ventilation is directly related to the number of infants in a multiple pregnancy, but even IVF singletons are at a relatively high risk of requiring ventilation.