Infertility treatment use in relation to selected adverse birth outcomes.

OBJECTIVE

To determine whether maternal infertility treatment is associated with adverse outcomes.

DESIGN

Population-based cohort study using linked birth certificate-hospital discharge data.

SETTING

Washington State.

PATIENT(S): Live-born singleton infants conceived with infertility treatment between 2003 and 2006 (n = 2,182) and a random sample of live-born singleton infants conceived spontaneously, frequency matched by birth year (n = 10,989).

INTERVENTION(S): None.

MAIN OUTCOME MEASURE(S): Mantel-Haenszel adjusted relative risks (RRs) and 95% confidence intervals (CIs) were computed for low birth weight, delivery at <37 weeks, small for gestational age infants, any malformation, placenta previa, and placenta abruptio.

RESULT(S): Women with infertility treatment were at increased risk of placental abnormalities, including placenta abruptio (RR, 1.6; 95% CI, 1.1-2.5) and placenta previa (RR, 3.0; 95% CI, 2.0-4.7). Their infants were more likely to be delivered at <37 weeks (RR, 1.7; 95% CI, 1.4-1.9) or weigh <2500 g (RR, 1.4; 95% CI, 1.1-1.7); however, they were not at increased risk of being small for gestational age. An increased risk of malformations was observed in infants born to older women with infertility treatment, but not to younger women.

CONCLUSION(S): Women using infertility treatment are at increased risk for delivering preterm, placenta previa, and placenta abruptio. Studies with measurement of specific infertility treatments will help identify the mechanisms.