Obstetric consequences of subfertility: a retrospective cohort study.

Autor: DoPierala, AL, Bhatta, S, Raja, EA, Bhattacharya, S, DoPierala, A L, Raja, E A
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Zdroj: BJOG: An International Journal of Obstetrics & Gynaecology; Jul2016, Vol. 123 Issue 8, p1320-1328, 9p, 4 Charts
Abstrakt: 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, ScotlandPopulation: 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. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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