The association between body mass index and live birth and maternal and perinatal outcomes after in-vitro fertilization: a national cohort study
ObjectiveTo investigate the association between female body mass index (BMI) and live birth rates and maternal and perinatal outcomes after in-vitro fertilization (IVF).MethodsWe performed a national, population-based cohort study including women undergoing IVF between 2002 and 2020. The cohort incl...
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Frontiers Media S.A.
2023-09-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2023.1239702/full |
| _version_ | 1797688626515017728 |
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| author | Linda Kluge Linda Kluge Karin Källén Ann Thurin-Kjellberg Ann Thurin-Kjellberg Ulla-Britt Wennerholm Ulla-Britt Wennerholm Christina Bergh Christina Bergh |
| author_facet | Linda Kluge Linda Kluge Karin Källén Ann Thurin-Kjellberg Ann Thurin-Kjellberg Ulla-Britt Wennerholm Ulla-Britt Wennerholm Christina Bergh Christina Bergh |
| author_sort | Linda Kluge |
| collection | DOAJ |
| description | ObjectiveTo investigate the association between female body mass index (BMI) and live birth rates and maternal and perinatal outcomes after in-vitro fertilization (IVF).MethodsWe performed a national, population-based cohort study including women undergoing IVF between 2002 and 2020. The cohort included 126,620 fresh cycles and subsequent frozen embryo transfers between 2007 and 2019 (subpopulation 1) and 58,187 singleton deliveries between 2002 and 2020 (subpopulation 2). Exposure was female BMI (kg/m2) categorized according to the World Health Organization as underweight (<18.5), normal weight (18.5–24.9, reference), overweight (25.0–29.9), class I obesity (30.0–34.9), class II obesity (35.0–39.9), and class III obesity (≥40.0). The primary outcome in subpopulation 1 was cumulative live birth per started fresh IVF cycle, including fresh and subsequent frozen embryo transfers. Primary outcomes in subpopulation 2 were hypertensive disorders of pregnancy and preterm birth at less than 37 weeks. Risk ratios (RRs) with 95% confidence intervals (CIs) for the association between BMI class and outcomes were calculated using generalized linear models after adjustment for relevant confounders.ResultsThe cumulative live birth rate decreased significantly with increasing BMI from 32.6% in normal-weight women to 29.4% in overweight women, 27.0% in women in obesity class I, 21.8% in women in obesity class II, and 7.6% in women in obesity class III. The risk of hypertensive disorders of pregnancy increased significantly and progressively with increasing BMI, from 4.6% in normal-weight women to 7.8% in overweight women and 12.5%, 17.9%, and 20.3% in women in obesity classes I, II, and III. The risk of preterm birth followed a similar pattern, from 6.3% in normal-weight women to 7.5% in overweight women and 8.9%, 9.9%, and 15.3% in women in obesity classes I, II, and III. The risks of other perinatal complications, such as perinatal death, showed an even more pronounced increase.ConclusionUsing a large and complete national cohort of women undergoing IVF, we demonstrate a dose-dependent decrease in live birth rate and a substantial increase in maternal and perinatal complications with increasing BMI. Strategies to improve this situation are warranted. |
| first_indexed | 2024-03-12T01:34:30Z |
| format | Article |
| id | doaj.art-bc65b333e0fe498c9b470aa4c572724c |
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| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-03-12T01:34:30Z |
| publishDate | 2023-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-bc65b333e0fe498c9b470aa4c572724c2023-09-11T12:26:51ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922023-09-011410.3389/fendo.2023.12397021239702The association between body mass index and live birth and maternal and perinatal outcomes after in-vitro fertilization: a national cohort studyLinda Kluge0Linda Kluge1Karin Källén2Ann Thurin-Kjellberg3Ann Thurin-Kjellberg4Ulla-Britt Wennerholm5Ulla-Britt Wennerholm6Christina Bergh7Christina Bergh8Department of Obstetrics and Gynaecology, Institute of Clinical Science, Sahlgrenska Academy, Gothenburg University, Gothenburg, SwedenReproductive Medicine, Sahlgrenska University Hospital, Gothenburg, SwedenDepartment of Reproduction Epidemiology, Tornblad Institute, Institute of Clinical Science, Lund University, Lund, SwedenDepartment of Obstetrics and Gynaecology, Institute of Clinical Science, Sahlgrenska Academy, Gothenburg University, Gothenburg, SwedenReproductive Medicine, Sahlgrenska University Hospital, Gothenburg, SwedenDepartment of Obstetrics and Gynaecology, Institute of Clinical Science, Sahlgrenska Academy, Gothenburg University, Gothenburg, SwedenDepartment of Obstetrics and Gynaecology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, SwedenDepartment of Obstetrics and Gynaecology, Institute of Clinical Science, Sahlgrenska Academy, Gothenburg University, Gothenburg, SwedenReproductive Medicine, Sahlgrenska University Hospital, Gothenburg, SwedenObjectiveTo investigate the association between female body mass index (BMI) and live birth rates and maternal and perinatal outcomes after in-vitro fertilization (IVF).MethodsWe performed a national, population-based cohort study including women undergoing IVF between 2002 and 2020. The cohort included 126,620 fresh cycles and subsequent frozen embryo transfers between 2007 and 2019 (subpopulation 1) and 58,187 singleton deliveries between 2002 and 2020 (subpopulation 2). Exposure was female BMI (kg/m2) categorized according to the World Health Organization as underweight (<18.5), normal weight (18.5–24.9, reference), overweight (25.0–29.9), class I obesity (30.0–34.9), class II obesity (35.0–39.9), and class III obesity (≥40.0). The primary outcome in subpopulation 1 was cumulative live birth per started fresh IVF cycle, including fresh and subsequent frozen embryo transfers. Primary outcomes in subpopulation 2 were hypertensive disorders of pregnancy and preterm birth at less than 37 weeks. Risk ratios (RRs) with 95% confidence intervals (CIs) for the association between BMI class and outcomes were calculated using generalized linear models after adjustment for relevant confounders.ResultsThe cumulative live birth rate decreased significantly with increasing BMI from 32.6% in normal-weight women to 29.4% in overweight women, 27.0% in women in obesity class I, 21.8% in women in obesity class II, and 7.6% in women in obesity class III. The risk of hypertensive disorders of pregnancy increased significantly and progressively with increasing BMI, from 4.6% in normal-weight women to 7.8% in overweight women and 12.5%, 17.9%, and 20.3% in women in obesity classes I, II, and III. The risk of preterm birth followed a similar pattern, from 6.3% in normal-weight women to 7.5% in overweight women and 8.9%, 9.9%, and 15.3% in women in obesity classes I, II, and III. The risks of other perinatal complications, such as perinatal death, showed an even more pronounced increase.ConclusionUsing a large and complete national cohort of women undergoing IVF, we demonstrate a dose-dependent decrease in live birth rate and a substantial increase in maternal and perinatal complications with increasing BMI. Strategies to improve this situation are warranted.https://www.frontiersin.org/articles/10.3389/fendo.2023.1239702/fullobesityin vitro fertilizationlive birthmaternal and perinatal outcomespopulation registers |
| spellingShingle | Linda Kluge Linda Kluge Karin Källén Ann Thurin-Kjellberg Ann Thurin-Kjellberg Ulla-Britt Wennerholm Ulla-Britt Wennerholm Christina Bergh Christina Bergh The association between body mass index and live birth and maternal and perinatal outcomes after in-vitro fertilization: a national cohort study Frontiers in Endocrinology obesity in vitro fertilization live birth maternal and perinatal outcomes population registers |
| title | The association between body mass index and live birth and maternal and perinatal outcomes after in-vitro fertilization: a national cohort study |
| title_full | The association between body mass index and live birth and maternal and perinatal outcomes after in-vitro fertilization: a national cohort study |
| title_fullStr | The association between body mass index and live birth and maternal and perinatal outcomes after in-vitro fertilization: a national cohort study |
| title_full_unstemmed | The association between body mass index and live birth and maternal and perinatal outcomes after in-vitro fertilization: a national cohort study |
| title_short | The association between body mass index and live birth and maternal and perinatal outcomes after in-vitro fertilization: a national cohort study |
| title_sort | association between body mass index and live birth and maternal and perinatal outcomes after in vitro fertilization a national cohort study |
| topic | obesity in vitro fertilization live birth maternal and perinatal outcomes population registers |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2023.1239702/full |
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