Preterm delivery and low birth weight in singleton pregnancies conceived by women with and without a history of infertility

Capsule:
Nulliparous women and women with a history of infertility who conceive a singleton after infertility treatment may be at increased risk for having a low-birthweight infant.

Authors:
Loretta Camarano, Ph.D., R.N.C., Abbey Alkon, Ph.D., P.N.P., Robert D. Nachtigall, M.D., Michael Schembri, M.S., Sandra Weiss, Ph.D., D.N.Sc., Mary S. Croughan, Ph.D.

Volume 98, Issue 3, Pages 681-686.e1, September 2012

Abstract:

Objective:
To determine predictors of low birth weight (LBW) and preterm delivery (PTD) in
singleton pregnancies conceived by women with and without a history of infertility.

Design:
Retrospective cohort study.

Setting:
Eleven infertility clinics in Northern California.

Patients:
Three groups of women who carried singleton pregnancies to ≥ 20 weeks gestation: 542 infertile women who conceived after treatment, 441 infertile women who conceived spontaneously, and 1008 fertile women for comparison.

Interventions:
Chart review.

Main Outcome Measures:
Association of LBW or PTD with infertility treatment, maternal age, parity, obesity, or development of gestational diabetes.

Results:
Infertile women who conceived with treatment were more likely to be obese, develop gestational diabetes, and have ovarian, ovulatory, or male factor infertility than infertile women who conceived spontaneously. Infertile women who conceived after treatment had 1.61 (95% CI 1.08– 2.41) times greater odds of having a LBW infant. Nulliparity was an independent predictor of LBW 1.54 (95% CI 1.09– 2.16) and PTD (OR 1.72, 95% CI 1.20-2.49) in all three groups after controlling for maternal age, history of infertility, infertility treatment, obesity, and gestational diabetes.

Conclusions:
Nulliparous women and women with a history of infertility who conceive a singleton after treatment may be at increased odds for having a LBW infant. Infertile women do not appear to be at increased odds for PTD.

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