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Obstetric consequences of subfertility: a retrospective cohort study.
BJOG. 2016 Jul; 123(8):1320-8.BJOG

Abstract

OBJECTIVE

To compare the risk of adverse pregnancy outcomes in women with and without subfertility and to investigate whether fertility treatment contributes to the adverse outcomes.

DESIGN

Register-based retrospective cohort study.

SETTING

Aberdeen, Scotland

POPULATION

The exposed group included women with subfertility attending Aberdeen Fertility Clinic between 1989 and 2008 and delivering a singleton (n = 3188) or twin (n = 350) at Aberdeen Maternity Hospital between 1992 and 2009. The unexposed cohort included the remainder of women (singleton n = 52443, twin n = 1125) delivering at Aberdeen Maternity Hospital between 1992 and 2009.

METHODS

The Aberdeen Fertility Centre database and Aberdeen Maternity and Neonatal Databank were linked using Community Health Index numbers. Regression models were used to calculate risk ratios and 95% confidence intervals adjusting for potential confounders.

MAIN OUTCOME MEASURES

Maternal outcomes including pre-eclampsia, antepartum haemorrhage, preterm birth, induction of labour; delivery outcomes including operative vaginal delivery, caesarean section; and offspring outcomes including low birthweight, stillbirth and neonatal death.

RESULTS

Women with a history of subfertility who delivered a singleton were at a higher risk of pre-eclampsia [adjusted risk ratios (aRR) 1.18, 95% confidence intervals (CI) 1.02-1.37], antepartum haemorrhage (aRR 1.32, 95% CI 1.18-1.47), induction of labour (aRR 1.21, 95% CI 1.11-1.31) and very preterm delivery (<32 weeks) (aRR 1.96, 95% CI 1.53-2.49). Subfertile women delivering twins were at a higher risk of being delivered by emergency caesarean section (aRR 2.14, 95% CI 1.26-3.66). There were no significant differences in adverse outcomes for singleton pregnancies between the treated and untreated subfertile couples.

CONCLUSION

Subfertility per se, rather than fertility treatment, was associated with increased risk of adverse outcomes in singleton pregnancies.

TWEETABLE ABSTRACT

Large cohort study found higher incidence of adverse outcome in subfertile women having singletons or twins.

Authors+Show Affiliations

School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK.Obstetrics and gynaecology, Division of Applied Health Sciences, School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK.Medical Statistics Team, Division of Applied Health Sciences, University of Aberdeen, Foresterhill, Aberdeen, UK.Obstetrics and gynaecology, Division of Applied Health Sciences, School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK.Epidemiology Group, Division of Applied Health Sciences, School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK.

Pub Type(s)

Journal Article
Video-Audio Media

Language

eng

PubMed ID

26335260

Citation

DoPierala, A L., et al. "Obstetric Consequences of Subfertility: a Retrospective Cohort Study." BJOG : an International Journal of Obstetrics and Gynaecology, vol. 123, no. 8, 2016, pp. 1320-8.
DoPierala AL, Bhatta S, Raja EA, et al. Obstetric consequences of subfertility: a retrospective cohort study. BJOG. 2016;123(8):1320-8.
DoPierala, A. L., Bhatta, S., Raja, E. A., Bhattacharya, S., & Bhattacharya, S. (2016). Obstetric consequences of subfertility: a retrospective cohort study. BJOG : an International Journal of Obstetrics and Gynaecology, 123(8), 1320-8. https://doi.org/10.1111/1471-0528.13584
DoPierala AL, et al. Obstetric Consequences of Subfertility: a Retrospective Cohort Study. BJOG. 2016;123(8):1320-8. PubMed PMID: 26335260.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Obstetric consequences of subfertility: a retrospective cohort study. AU - DoPierala,A L, AU - Bhatta,S, AU - Raja,E A, AU - Bhattacharya,S, AU - Bhattacharya,S, Y1 - 2015/09/02/ PY - 2015/07/02/accepted PY - 2015/9/4/entrez PY - 2015/9/4/pubmed PY - 2018/8/17/medline KW - Cohort study KW - obstetric outcomes KW - pregnancy complications KW - subfertility SP - 1320 EP - 8 JF - BJOG : an international journal of obstetrics and gynaecology JO - BJOG VL - 123 IS - 8 N2 - OBJECTIVE: To compare the risk of adverse pregnancy outcomes in women with and without subfertility and to investigate whether fertility treatment contributes to the adverse outcomes. DESIGN: Register-based retrospective cohort study. SETTING: Aberdeen, Scotland POPULATION: The exposed group included women with subfertility attending Aberdeen Fertility Clinic between 1989 and 2008 and delivering a singleton (n = 3188) or twin (n = 350) at Aberdeen Maternity Hospital between 1992 and 2009. The unexposed cohort included the remainder of women (singleton n = 52443, twin n = 1125) delivering at Aberdeen Maternity Hospital between 1992 and 2009. METHODS: The Aberdeen Fertility Centre database and Aberdeen Maternity and Neonatal Databank were linked using Community Health Index numbers. Regression models were used to calculate risk ratios and 95% confidence intervals adjusting for potential confounders. MAIN OUTCOME MEASURES: Maternal outcomes including pre-eclampsia, antepartum haemorrhage, preterm birth, induction of labour; delivery outcomes including operative vaginal delivery, caesarean section; and offspring outcomes including low birthweight, stillbirth and neonatal death. RESULTS: Women with a history of subfertility who delivered a singleton were at a higher risk of pre-eclampsia [adjusted risk ratios (aRR) 1.18, 95% confidence intervals (CI) 1.02-1.37], antepartum haemorrhage (aRR 1.32, 95% CI 1.18-1.47), induction of labour (aRR 1.21, 95% CI 1.11-1.31) and very preterm delivery (<32 weeks) (aRR 1.96, 95% CI 1.53-2.49). Subfertile women delivering twins were at a higher risk of being delivered by emergency caesarean section (aRR 2.14, 95% CI 1.26-3.66). There were no significant differences in adverse outcomes for singleton pregnancies between the treated and untreated subfertile couples. CONCLUSION: Subfertility per se, rather than fertility treatment, was associated with increased risk of adverse outcomes in singleton pregnancies. TWEETABLE ABSTRACT: Large cohort study found higher incidence of adverse outcome in subfertile women having singletons or twins. SN - 1471-0528 UR - https://www.unboundmedicine.com/medline/citation/26335260/Obstetric_consequences_of_subfertility:_a_retrospective_cohort_study_ L2 - https://doi.org/10.1111/1471-0528.13584 DB - PRIME DP - Unbound Medicine ER -