Complications and adverse outcomes in pregnancy and childbirth among women who conceived by assisted reproductive technologies: a nationwide birth cohort study of Japan environment and children’s study
Abstract Background Although pregnancies conceived by assisted reproductive technology (ART) have a higher risk of maternal/perinatal complications, the overall risk of adverse outcomes necessitating advanced obstetric care has not been closely examined. The present study aimed to assess and compare...
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| Format: | Article |
| Language: | English |
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BMC
2019-02-01
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| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12884-019-2213-y |
| _version_ | 1818065260519620608 |
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| author | Chie Nagata Limin Yang Kiwako Yamamoto-Hanada Hidetoshi Mezawa Tadayuki Ayabe Kazue Ishizuka Mizuho Konishi Yukihiro Ohya Hirohisa Saito Haruhiko Sago Japan Environment & Children’s Study Group |
| author_facet | Chie Nagata Limin Yang Kiwako Yamamoto-Hanada Hidetoshi Mezawa Tadayuki Ayabe Kazue Ishizuka Mizuho Konishi Yukihiro Ohya Hirohisa Saito Haruhiko Sago Japan Environment & Children’s Study Group |
| author_sort | Chie Nagata |
| collection | DOAJ |
| description | Abstract Background Although pregnancies conceived by assisted reproductive technology (ART) have a higher risk of maternal/perinatal complications, the overall risk of adverse outcomes necessitating advanced obstetric care has not been closely examined. The present study aimed to assess and compare the risk of maternal/perinatal complications and adverse outcomes in pregnancy and childbirth conceived by ART with those conceived naturally. Methods This study was conducted as a part of the Japan environment and children’s study (JECS), an ongoing nationwide birth cohort study in Japan. The risk of maternal/perinatal complications and adverse outcomes was assessed by mode of conception (natural conception, ovulation induction [OI] without ART, conventional in vitro fertilization and embryo transfer [IVF-ET], or intracytoplasmic sperm injection [ICSI]) using logistic regression and generalized estimating equations controlling for potential confounders. Results The final dataset included women who conceived naturally (N = 90,506), by OI without ART (N = 3939), by conventional IVF-ET (N = 1476), and by ICSI (N = 1671). Compared with women who conceived naturally, those who conceived by conventional IVF-ET were at higher risk of placenta previa (adjusted OR 2.90 [95% CI 1.94, 4.34]), morbidly adherent placenta (6.85 [3.88, 12.13]), and pregnancy-induced hypertension (1.40 [1.10, 1.78]) whereas those who conceived by ICSI had a higher risk of placental abruption (2.16 [1.20, 3.88]) as well as placenta previa (2.01 [1.29, 3.13]) and morbidly adherent placenta (7.81 [4.56, 13.38]). Women who conceived by ART had a higher risk of blood transfusion (conventional IVF-ET: 3.85 [2.52, 5.88]; ICSI: 3.76 [2.49, 5.66]) and ICU admission (conventional IVF-ET: 2.58 [1.11, 6.01]; ICSI: 3.45 [1.68, 7.06]) even after controlling for potential confounders. Neonates conceived by ART had a higher risk of preterm birth (conventional IVF-ET: 1.42 [1.13, 1.78]; ICSI: 1.31 [1.05, 1.64]). Conclusions Women who conceived by ART had a higher risk of maternal/perinatal complications necessitating advanced obstetric care. Obstetricians should be aware of the increased risk of adverse outcomes among this population. |
| first_indexed | 2024-12-10T14:49:04Z |
| format | Article |
| id | doaj.art-4bf8b6f496e54e10966646bf28eee8f8 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-12-10T14:49:04Z |
| publishDate | 2019-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-4bf8b6f496e54e10966646bf28eee8f82022-12-22T01:44:29ZengBMCBMC Pregnancy and Childbirth1471-23932019-02-0119111110.1186/s12884-019-2213-yComplications and adverse outcomes in pregnancy and childbirth among women who conceived by assisted reproductive technologies: a nationwide birth cohort study of Japan environment and children’s studyChie Nagata0Limin Yang1Kiwako Yamamoto-Hanada2Hidetoshi Mezawa3Tadayuki Ayabe4Kazue Ishizuka5Mizuho Konishi6Yukihiro Ohya7Hirohisa Saito8Haruhiko Sago9Japan Environment & Children’s Study GroupDepartment of Education for Clinical Research, National Center for Child Health and DevelopmentMedical Support Center for Japan Environment and Children’s Study (JECS), National Center for Child Health and DevelopmentMedical Support Center for Japan Environment and Children’s Study (JECS), National Center for Child Health and DevelopmentMedical Support Center for Japan Environment and Children’s Study (JECS), National Center for Child Health and DevelopmentMedical Support Center for Japan Environment and Children’s Study (JECS), National Center for Child Health and DevelopmentMedical Support Center for Japan Environment and Children’s Study (JECS), National Center for Child Health and DevelopmentMedical Support Center for Japan Environment and Children’s Study (JECS), National Center for Child Health and DevelopmentMedical Support Center for Japan Environment and Children’s Study (JECS), National Center for Child Health and DevelopmentMedical Support Center for Japan Environment and Children’s Study (JECS), National Center for Child Health and DevelopmentMedical Support Center for Japan Environment and Children’s Study (JECS), National Center for Child Health and DevelopmentAbstract Background Although pregnancies conceived by assisted reproductive technology (ART) have a higher risk of maternal/perinatal complications, the overall risk of adverse outcomes necessitating advanced obstetric care has not been closely examined. The present study aimed to assess and compare the risk of maternal/perinatal complications and adverse outcomes in pregnancy and childbirth conceived by ART with those conceived naturally. Methods This study was conducted as a part of the Japan environment and children’s study (JECS), an ongoing nationwide birth cohort study in Japan. The risk of maternal/perinatal complications and adverse outcomes was assessed by mode of conception (natural conception, ovulation induction [OI] without ART, conventional in vitro fertilization and embryo transfer [IVF-ET], or intracytoplasmic sperm injection [ICSI]) using logistic regression and generalized estimating equations controlling for potential confounders. Results The final dataset included women who conceived naturally (N = 90,506), by OI without ART (N = 3939), by conventional IVF-ET (N = 1476), and by ICSI (N = 1671). Compared with women who conceived naturally, those who conceived by conventional IVF-ET were at higher risk of placenta previa (adjusted OR 2.90 [95% CI 1.94, 4.34]), morbidly adherent placenta (6.85 [3.88, 12.13]), and pregnancy-induced hypertension (1.40 [1.10, 1.78]) whereas those who conceived by ICSI had a higher risk of placental abruption (2.16 [1.20, 3.88]) as well as placenta previa (2.01 [1.29, 3.13]) and morbidly adherent placenta (7.81 [4.56, 13.38]). Women who conceived by ART had a higher risk of blood transfusion (conventional IVF-ET: 3.85 [2.52, 5.88]; ICSI: 3.76 [2.49, 5.66]) and ICU admission (conventional IVF-ET: 2.58 [1.11, 6.01]; ICSI: 3.45 [1.68, 7.06]) even after controlling for potential confounders. Neonates conceived by ART had a higher risk of preterm birth (conventional IVF-ET: 1.42 [1.13, 1.78]; ICSI: 1.31 [1.05, 1.64]). Conclusions Women who conceived by ART had a higher risk of maternal/perinatal complications necessitating advanced obstetric care. Obstetricians should be aware of the increased risk of adverse outcomes among this population.http://link.springer.com/article/10.1186/s12884-019-2213-yAssisted reproductive technologyARTIn vitro fertilizationIVFIntracytoplasmic sperm injectionsICSI |
| spellingShingle | Chie Nagata Limin Yang Kiwako Yamamoto-Hanada Hidetoshi Mezawa Tadayuki Ayabe Kazue Ishizuka Mizuho Konishi Yukihiro Ohya Hirohisa Saito Haruhiko Sago Japan Environment & Children’s Study Group Complications and adverse outcomes in pregnancy and childbirth among women who conceived by assisted reproductive technologies: a nationwide birth cohort study of Japan environment and children’s study BMC Pregnancy and Childbirth Assisted reproductive technology ART In vitro fertilization IVF Intracytoplasmic sperm injections ICSI |
| title | Complications and adverse outcomes in pregnancy and childbirth among women who conceived by assisted reproductive technologies: a nationwide birth cohort study of Japan environment and children’s study |
| title_full | Complications and adverse outcomes in pregnancy and childbirth among women who conceived by assisted reproductive technologies: a nationwide birth cohort study of Japan environment and children’s study |
| title_fullStr | Complications and adverse outcomes in pregnancy and childbirth among women who conceived by assisted reproductive technologies: a nationwide birth cohort study of Japan environment and children’s study |
| title_full_unstemmed | Complications and adverse outcomes in pregnancy and childbirth among women who conceived by assisted reproductive technologies: a nationwide birth cohort study of Japan environment and children’s study |
| title_short | Complications and adverse outcomes in pregnancy and childbirth among women who conceived by assisted reproductive technologies: a nationwide birth cohort study of Japan environment and children’s study |
| title_sort | complications and adverse outcomes in pregnancy and childbirth among women who conceived by assisted reproductive technologies a nationwide birth cohort study of japan environment and children s study |
| topic | Assisted reproductive technology ART In vitro fertilization IVF Intracytoplasmic sperm injections ICSI |
| url | http://link.springer.com/article/10.1186/s12884-019-2213-y |
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