Tags

Type your tag names separated by a space and hit enter

Assisted fertilization and breech delivery: risks and obstetric management.
Hum Reprod. 2009 Dec; 24(12):3205-10.HR

Abstract

BACKGROUND

Previous studies have suggested that assisted reproduction technology (ART) is associated with increased risk of breech presentation. We investigated whether factors that tend to differ between ART and spontaneously conceived pregnancies may explain the higher risk of breech deliveries associated with ART.

MATERIAL AND METHODS

In this population-based cohort study, we included 1 209 151 singleton pregnancies reported to the Medical Birth Registry of Norway between 1984 and 2006 and compared the risk of breech presentation in 8229 ART pregnancies with that in spontaneously conceived pregnancies. Risk ratios (RR), adjusted for maternal age, parity, gestational length and year of birth, were estimated using binominal regression, and we describe differences and time trends in obstetric management for breech and cephalic presentations after ART compared with management of spontaneously conceived pregnancies.

RESULTS

Breech presentation occurred nearly 50% more often in ART singleton pregnancies than in spontaneously conceived singletons [crude RR: 1.48, 95% confidence interval (CI): 1.34-1.64], but after adjustment for potentially confounding factors, the difference was fully attenuated (RR: 0.97, 95% CI: 0.88-1.07). The most important contributors to the attenuation were parity and length of gestation. In general, Caesarean sections and induced deliveries were more likely in ART pregnancies, but over the study period, the proportion of Caesarean sections in ART pregnancies gradually approached that of spontaneously conceived pregnancies.

CONCLUSION

Increased risk of breech presentation in pregnancies after ART is mediated by lower parity and shorter gestational length. In general, the obstetric management of women with ART pregnancies is gradually approaching the ordinary surveillance of pregnant women.

Authors+Show Affiliations

Department of Obstetrics and Gynaecology, IVF Unit, St Olav's University Hospital, Trondheim NO-7006, Trondheim, Norway. libero@ntnu.noNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19700471

Citation

Romundstad, Liv Bente, et al. "Assisted Fertilization and Breech Delivery: Risks and Obstetric Management." Human Reproduction (Oxford, England), vol. 24, no. 12, 2009, pp. 3205-10.
Romundstad LB, Romundstad PR, Sunde A, et al. Assisted fertilization and breech delivery: risks and obstetric management. Hum Reprod. 2009;24(12):3205-10.
Romundstad, L. B., Romundstad, P. R., Sunde, A., von Düring, V., Skjaerven, R., & Vatten, L. J. (2009). Assisted fertilization and breech delivery: risks and obstetric management. Human Reproduction (Oxford, England), 24(12), 3205-10. https://doi.org/10.1093/humrep/dep301
Romundstad LB, et al. Assisted Fertilization and Breech Delivery: Risks and Obstetric Management. Hum Reprod. 2009;24(12):3205-10. PubMed PMID: 19700471.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Assisted fertilization and breech delivery: risks and obstetric management. AU - Romundstad,Liv Bente, AU - Romundstad,Pål R, AU - Sunde,Arne, AU - von Düring,Vidar, AU - Skjaerven,Rolv, AU - Vatten,Lars J, Y1 - 2009/08/21/ PY - 2009/8/25/entrez PY - 2009/8/25/pubmed PY - 2010/2/13/medline SP - 3205 EP - 10 JF - Human reproduction (Oxford, England) JO - Hum. Reprod. VL - 24 IS - 12 N2 - BACKGROUND: Previous studies have suggested that assisted reproduction technology (ART) is associated with increased risk of breech presentation. We investigated whether factors that tend to differ between ART and spontaneously conceived pregnancies may explain the higher risk of breech deliveries associated with ART. MATERIAL AND METHODS: In this population-based cohort study, we included 1 209 151 singleton pregnancies reported to the Medical Birth Registry of Norway between 1984 and 2006 and compared the risk of breech presentation in 8229 ART pregnancies with that in spontaneously conceived pregnancies. Risk ratios (RR), adjusted for maternal age, parity, gestational length and year of birth, were estimated using binominal regression, and we describe differences and time trends in obstetric management for breech and cephalic presentations after ART compared with management of spontaneously conceived pregnancies. RESULTS: Breech presentation occurred nearly 50% more often in ART singleton pregnancies than in spontaneously conceived singletons [crude RR: 1.48, 95% confidence interval (CI): 1.34-1.64], but after adjustment for potentially confounding factors, the difference was fully attenuated (RR: 0.97, 95% CI: 0.88-1.07). The most important contributors to the attenuation were parity and length of gestation. In general, Caesarean sections and induced deliveries were more likely in ART pregnancies, but over the study period, the proportion of Caesarean sections in ART pregnancies gradually approached that of spontaneously conceived pregnancies. CONCLUSION: Increased risk of breech presentation in pregnancies after ART is mediated by lower parity and shorter gestational length. In general, the obstetric management of women with ART pregnancies is gradually approaching the ordinary surveillance of pregnant women. SN - 1460-2350 UR - https://www.unboundmedicine.com/medline/citation/19700471/Assisted_fertilization_and_breech_delivery:_risks_and_obstetric_management_ L2 - https://academic.oup.com/humrep/article-lookup/doi/10.1093/humrep/dep301 DB - PRIME DP - Unbound Medicine ER -