Low technology assisted reproduction and the risk of preterm birth in a hospital based cohort

Capsule:
In a hospital-based cohort, intrauterine insemination and/or ovulation induction/stimulation was associated with increased risk of preterm birth at <37, <35, and

Authors:
Carmen Messerlian, Ph.D., Robert W. Platt, Ph.D., Seang-Lin Tan, M.D., Robert Gagnon, M.D., Olga Basso, Ph.D.

Volume 103, Issue 1, Pages 81-88

Abstract:

Objective:
To estimate the risk of preterm birth in singleton infants conceived through low-technology assisted reproduction (intrauterine insemination and/or ovulation induction/stimulation).

Design:
Hospital-based cohort study.

Setting:
University-affiliated hospital.

Patient(s):
Singleton babies born between 2001 and 2007 to 16,712 couples with no reported infertility (reference category), 378 babies conceived with low-technology treatment; 437 conceived with high-technology treatment; and 620 conceived naturally after a period of infertility.

Intervention(s):
None. Treatment data were obtained from couples undergoing standard infertility investigation and care.

Main Outcome Measure(s):
Preterm birth, defined at three clinical endpoints: <37, <35, and

Result(s):
After adjustment for age, parity, education, smoking, alcohol/drug use, and body mass index, the risk ratios and 95% confidence intervals (CI) of preterm birth for low technology were: 1.49 (CI: 1.12–2.00); 2.02 (CI: 1.30–3.13); and 2.93 (CI: 1.63–5.26) at <37, <35, and

Conclusion(s):
In this large hospital-based cohort study, low-technology assisted reproduction appeared to be a moderately strong predictor of preterm birth, with similar associations observed in the high-technology treatment group. After adjusting for confounders, as well as the shared characteristics of infertile couples, associations were attenuated but remained significant, suggesting that part of the risk is likely attributable to the treatment.

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