Health of infants after ART-Treated, subfertile, and fertile deliveries

Sunah S. Hwang, Dmitry Dukhovny, Daksha Gopal, Howard Cabral, Stacey Missmer, Hafsatou Diop, Eugene Declercq, Judy E. Stern

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

OBJECTIVES: To assess the risk of adverse health outcomes for infants after assisted reproductive technology (ART)–treated and subfertile as compared with fertile deliveries. METHODS: Live-born singleton infants ≥23 weeks’ gestational age (GA) born in Massachusetts between July 1, 2004, and December 31, 2010, were analyzed by linking a clinical ART database with state vital records. χ2 tests were used to compare the outcomes of fertile (those without ART treatment or other indicators of infertility), subfertile (indicators of infertility, no ART), and ART-treated (linked to ART deliveries) mothers, stratified by GA. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated by using multivariate logistic regression within each GA stratum, controlling for maternal sociodemographic and health characteristics. RESULTS: Compared with infants of fertile mothers (n = 336 705), infants born to subfertile (n = 5043) or ART-treated (n = 8375) mothers were more likely to be preterm (aOR 1.39 [95% CI 1.26–1.54] and aOR 1.72 [95% CI 1.60–1.85], respectively) and have respiratory and gastrointestinal and/or nutritional conditions (aOR range: 1.12–1.18). When stratified by GA, infants of subfertile or ART-treated mothers were at greater risk for congenital malformations and infectious diseases as well as cardiovascular and respiratory conditions (aOR range: 1.30–2.61; 95% CI range: 1.02–4.59). Compared with infants born to subfertile mothers, infants born to ART-treated mothers were at lower risk for being small for GA and having congenital malformations and cardiovascular conditions and at higher risk for infectious disease conditions. CONCLUSIONS: Compared with infants born to fertile mothers, infants of subfertile and ART-treated mothers are at greater risk for adverse health outcomes at birth beyond prematurity. The occurrence and magnitude of these risks vary by GA and organ systems.

Original languageEnglish (US)
Article numbere20174069
JournalPediatrics
Volume142
Issue number2
DOIs
StatePublished - Aug 1 2018

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Assisted Reproductive Techniques
Mothers
Gestational Age
Confidence Intervals
Infertility
Communicable Diseases
Infant Health
Logistic Models
Odds Ratio
Parturition
Databases

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Hwang, S. S., Dukhovny, D., Gopal, D., Cabral, H., Missmer, S., Diop, H., ... Stern, J. E. (2018). Health of infants after ART-Treated, subfertile, and fertile deliveries. Pediatrics, 142(2), [e20174069]. https://doi.org/10.1542/peds.2017-4069

Health of infants after ART-Treated, subfertile, and fertile deliveries. / Hwang, Sunah S.; Dukhovny, Dmitry; Gopal, Daksha; Cabral, Howard; Missmer, Stacey; Diop, Hafsatou; Declercq, Eugene; Stern, Judy E.

In: Pediatrics, Vol. 142, No. 2, e20174069, 01.08.2018.

Research output: Contribution to journalArticle

Hwang, SS, Dukhovny, D, Gopal, D, Cabral, H, Missmer, S, Diop, H, Declercq, E & Stern, JE 2018, 'Health of infants after ART-Treated, subfertile, and fertile deliveries', Pediatrics, vol. 142, no. 2, e20174069. https://doi.org/10.1542/peds.2017-4069
Hwang SS, Dukhovny D, Gopal D, Cabral H, Missmer S, Diop H et al. Health of infants after ART-Treated, subfertile, and fertile deliveries. Pediatrics. 2018 Aug 1;142(2). e20174069. https://doi.org/10.1542/peds.2017-4069
Hwang, Sunah S. ; Dukhovny, Dmitry ; Gopal, Daksha ; Cabral, Howard ; Missmer, Stacey ; Diop, Hafsatou ; Declercq, Eugene ; Stern, Judy E. / Health of infants after ART-Treated, subfertile, and fertile deliveries. In: Pediatrics. 2018 ; Vol. 142, No. 2.
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abstract = "OBJECTIVES: To assess the risk of adverse health outcomes for infants after assisted reproductive technology (ART)–treated and subfertile as compared with fertile deliveries. METHODS: Live-born singleton infants ≥23 weeks’ gestational age (GA) born in Massachusetts between July 1, 2004, and December 31, 2010, were analyzed by linking a clinical ART database with state vital records. χ2 tests were used to compare the outcomes of fertile (those without ART treatment or other indicators of infertility), subfertile (indicators of infertility, no ART), and ART-treated (linked to ART deliveries) mothers, stratified by GA. Adjusted odds ratios (aORs) and 95{\%} confidence intervals (CIs) were calculated by using multivariate logistic regression within each GA stratum, controlling for maternal sociodemographic and health characteristics. RESULTS: Compared with infants of fertile mothers (n = 336 705), infants born to subfertile (n = 5043) or ART-treated (n = 8375) mothers were more likely to be preterm (aOR 1.39 [95{\%} CI 1.26–1.54] and aOR 1.72 [95{\%} CI 1.60–1.85], respectively) and have respiratory and gastrointestinal and/or nutritional conditions (aOR range: 1.12–1.18). When stratified by GA, infants of subfertile or ART-treated mothers were at greater risk for congenital malformations and infectious diseases as well as cardiovascular and respiratory conditions (aOR range: 1.30–2.61; 95{\%} CI range: 1.02–4.59). Compared with infants born to subfertile mothers, infants born to ART-treated mothers were at lower risk for being small for GA and having congenital malformations and cardiovascular conditions and at higher risk for infectious disease conditions. CONCLUSIONS: Compared with infants born to fertile mothers, infants of subfertile and ART-treated mothers are at greater risk for adverse health outcomes at birth beyond prematurity. The occurrence and magnitude of these risks vary by GA and organ systems.",
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AU - Stern, Judy E.

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