Admissions for early parenting difficulties among women with infants conceived by assisted reproductive technologies: a prospective cohort study

Capsule:
Women who conceive with assisted reproductive technology are at a more than three-fold increased risk of hospital admission for early parenting difficulties compared with women who conceive spontaneously.

Authors:
Jane R.W. Fisher, Ph.D., Heather Rowe, Ph.D., Karin Hammarberg, Ph.D.
Volume 97, Issue 6 , Pages 1410-1416, June 2012

Objective:
To describe rate of and risks for residential early parenting service (REPS) admissions in women with infants conceived with assisted reproductive technology (ART).

Design:
A prospective study of women who conceived with ART. Self-report telephone interview and questionnaire data were collected in two pregnancy and three postpartum waves.

Setting:
Melbourne IVF and Royal Women’s Hospital Reproductive Services, Victoria, Australia.

Patient(s):
A consecutive cohort of women with ART pregnancies.

Intervention(s):
None.

Main Outcome Measure(s):
REPS admission up to 18 months postpartum.

Result(s):
Of 239 eligible women. 183 (77%) were recruited, six experienced pregnancy loss, and 153/177 (86%) were retained. In total, 17% (26/153) of participants were admitted to a REPS, 3.37 times more than the population admission rate of 5.05%. Admission risk was increased by primiparity, inadequate breastfeeding advice, low caregiving confidence when discharged from maternity hospital, lower early postpartum mood, unsettled infant behavior, and insufficient help from others.

Conclusion(s):
Compared with spontaneous conception, women who conceived with ART are at elevated risk of early parenting difficulties. Early interventions to address breastfeeding difficulties, management of unsettled infant behavior, social isolation, and postpartum anxiety are indicated.

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