Maternal characteristics and pregnancy outcomes after assisted reproductive technology by infertility diagnosis ovulatory dysfunction versus tubal obstruction

Capsule:
This study examined the differences in maternal characteristics and pregnancy outcomes between women with ovulatory dysfunction and tubal obstruction who underwent assisted reproductive techniques.

Authors:
Violanda Grigorescu, M.D., M.S.P.H., Yujia Zhang, Ph.D., Dmitry M. Kissin, M.D., M.P.H., Erin Sauber-Schatz, Ph.D., M.P.H., Mithi Sunderam, Ph.D., M.A., Russell S. Kirby, Ph.D., M.S., Hafsatou Diop, M.D., M.P.H., Patricia McKane, D.V.M., M.P.H., Denise J. Jamieson , M.D., M.P.H.

Volume 101, Issue 4, Pages 1019-1025

Abstract:

Objective:
To examine differences in maternal characteristics and pregnancy outcomes between women with ovulatory dysfunction (OD) and women with tubal obstruction (TO) who underwent assisted reproductive technology (ART).

Design:
Retrospective cohort study.

Setting:
Centers for Disease Control and Prevention.

Patient(s):
Exposed and nonexposed groups were selected from the 2000–2006 National ART Surveillance System linked with live-birth certificates from three states: Florida, Massachusetts, and Michigan.

Intervention(s):
None.

Main Outcome Measure(s):
Maternal characteristics and pregnancy outcomes, including newborn’s health status right after delivery (Apgar score, <7 vs. ≥7) as the study outcome of interest, were assessed among women with OD/polycystic ovary syndrome (PCOS) and TO who used ART. Result(s):
A significantly higher prevalence of women with OD/PCOS were younger (<35 years of age; 65.7% vs. 48.9%), were white (85.4% vs. 74.4%), had higher education (29.4% vs. 15.6%), and experienced diabetes (8.8% vs. 5.3%) compared with those having TO. The odds of having a lower (<7) Apgar score at 5 minutes were almost twice as high among newborns of women with OD/PCOS compared with those with TO (crude odds ratio, 1.86; 95% confidence interval [CI], 1.31, 2.64; adjusted odds ratio, 1.90; 95% CI, 1.30, 2.77). Conclusion(s):
Women with OD/PCOS who underwent ART have different characteristics and health issues (higher prevalence of diabetes) and infant outcomes (lower Apgar score) compared with women with TO.

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