Comprehensive appraisal of pregnancy and neonatal outcomes in singleton pregnancies conceived via in vitro fertilization in the USA (2016–2021)

Liron Bar-El; Erez Lenchner; Moti Gulersen; Samantha Gobioff; Arielle Yeshua; Yael Eliner; Amos Grünebaum; Frank A. Chervenak; Eran Bornstein

doi:10.1515/jpm-2023-0409

Published by De Gruyter December 22, 2023

Comprehensive appraisal of pregnancy and neonatal outcomes in singleton pregnancies conceived via in vitro fertilization in the USA (2016–2021)

Liron Bar-El , Erez Lenchner , Moti Gulersen , Samantha Gobioff , Arielle Yeshua , Yael Eliner , Amos Grünebaum , Frank A. Chervenak and Eran Bornstein

From the journal Journal of Perinatal Medicine

https://doi.org/10.1515/jpm-2023-0409

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Abstract

Objectives

We set out to compare adverse pregnancy and neonatal outcomes in singleton gestations conceived via in vitro fertilization (IVF) to those conceived spontaneously.

Methods

Retrospective, population-based cohort using the CDC Natality Live Birth database (2016–2021). All singleton births were stratified into two groups: those conceived via IVF, and those conceived spontaneously. The incidence of several adverse pregnancy and neonatal outcomes was compared between the two groups using Pearson’s chi-square test with Bonferroni adjustments. Multivariate logistic regression was used to adjust outcomes for potential confounders.

Results

Singleton live births conceived by IVF comprised 0.86 % of the cohort (179,987 of 20,930,668). Baseline characteristics varied significantly between the groups. After adjusting for confounding variables, pregnancies conceived via IVF were associated with an increased risk of several adverse pregnancy and neonatal outcomes compared to those conceived spontaneously. The maternal adverse outcomes with the highest risk in IVF pregnancies included maternal transfusion, unplanned hysterectomy, and maternal intensive care unit admission. Increased rates of hypertensive disorder of pregnancy, preterm birth (delivery <37 weeks of gestation), and cesarean delivery were also noted. The highest risk neonatal adverse outcomes associated with IVF included immediate and prolonged ventilation, neonatal seizures, and neonatal intensive care unit admissions, among others.

Conclusions

Based on this large contemporary United States cohort, the risk of several adverse pregnancy and neonatal outcomes is increased in singleton pregnancies conceived via IVF compared to those conceived spontaneously. Obstetricians should be conscious of these associations while caring for and counseling pregnancies conceived via IVF.

Keywords: risk factors; pregnancy outcomes; neonatal outcomes; complications; assisted reproductive treatment

Corresponding author: Liron Bar-El, MD, Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Lenox Hill Hospital/Northwell Health – Zucker School of Medicine at Hofstra, 100 East 77th Street, New York, NY, 10075, USA; and Obstetrics and Gynecology & Women’s Health Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA, E-mail: Lironbarel@gmail.com

Erez Lenchner, Moti Gulersen, Samantha Gobioff, Arielle Yeshua, Yael Eliner, Amos Grünebaum, and Frank A. Chervenak contributed equally to this work.

Liron Bar-El is the first author.

Eran Bornstein is the senior author.

Research ethics: An institutional review board approval was not required as the reported de-identified data are publicly available through a data use agreement with the National Center for Health Statistics.
Informed consent: Not applicable.
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Competing interests: The authors state no conflict of interest.
Research funding: None declared.
Data availability: Not applicable.

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Article note

An institutional review board approval was not required as the reported de-identified data are publicly available through a data use agreement with the National Center for Health Statistics.

This study was presented as a poster presentation (final abstract number 1121) at the 41st annual Society for Maternal-Fetal Medicine meeting, held virtually, January 25th – 30th, 2021.

Received: 2023-09-29

Accepted: 2023-11-11

Published Online: 2023-12-22

Published in Print: 2024-03-25