Risk factors associated with preterm birth in singletons born after IVF: a national cohort study.
Reprod Biomed Online
; 46(4): 750-759, 2023 04.
Article
em En
| MEDLINE
| ID: mdl-36868885
ABSTRACT
RESEARCH QUESTION What are the risk factors for prematurity other than intrauterine growth restriction in singletons after IVF? DESIGN:
Data were collected from a national registry, based on an observational prospective cohort of 30,737 live births after assisted reproductive technology (fresh embryo transfers nâ¯=â¯20,932 and frozen embryo transfer [FET] nâ¯=â¯9805) between 2014 and 2015. A population of not-small for gestational age singletons conceived after fresh embryo transfers and FET, and their parents, was selected. Data on a number of variables were collected, including type of infertility, number of oocytes retrieved and vanishing twins.RESULTS:
Preterm birth occurred in 7.7% (nâ¯=â¯1607) of fresh embryo transfers and 6.2% (nâ¯=â¯611) of frozen-thawed embryo transfers (P < 0.0001; adjusted odds ratio [aOR]â¯=â¯1.34 [1.21-1.49]). Endometriosis and vanishing twin increased the risk of preterm birth after fresh embryo transfer (P < 0.001; aOR 1.32 and 1.78, respectively). Polycystic ovaries or more than 20 oocytes retrieved also increased preterm birth risk (aOR 1.31 and 1.30; Pâ¯=â¯0.003 and Pâ¯=â¯0.02, respectively); large oocyte cohort (>20) was no longer associated with the risk of prematurity in FET.CONCLUSION:
Endometriosis remains a risk for prematurity even in the absence of intrauterine growth retardation, which suggests a dysimmune effect. Large oocyte cohorts obtained by stimulation, without clinical polycystic ovary syndrome diagnosed before attempts, do not affect FET outcomes, reinforcing the idea of a phenotypic difference in the clinical presentation of polycystic ovary syndrome.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Síndrome do Ovário Policístico
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Nascimento Prematuro
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Endometriose
Tipo de estudo:
Etiology_studies
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Incidence_studies
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Observational_studies
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Risk_factors_studies
Limite:
Female
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Humans
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Newborn
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Pregnancy
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article