1121 Comprehensive appraisal of outcomes in singleton pregnancies conceived via in vitro fertilization: US 2016-2018

Abstract

We set out to better define pregnancy and neonatal outcomes in singleton gestations conceived via in vitro fertilization (IVF). Retrospective analysis of the Centers for Disease Control and Prevention, Natality Live Birth database (2016-2018). All singleton births conceived via IVF comprised the study group while those conceived spontaneously served as controls. Pearson’s chi-square test with Bonferroni adjustment were used to compare baseline characteristics as well as several pregnancy and neonatal outcomes. Multivariate logistic regression was used to adjust outcomes for potential confounders such as maternal age, race/ethnicity, body mass index (BMI), chronic hypertension, pregestational diabetes, and prior preterm birth. Results were presented as adjusted odds ratios (aOR) with 95% confidence intervals (CI), and statistical significance was set as P value < 0.05. IVF singleton births comprised 0.84% of the study cohort (83,624 of 9,936,721). Baseline characteristics such as maternal age, BMI, race/ethnicity, pre-gestational diabetes, and smoking varied significantly between the groups (Table 1). IVF pregnancies were associated with several adverse pregnancy and neonatal outcomes including hypertension disorders of pregnancy (aOR 1.73, CI 1.64-1.77), maternal transfusion (aOR 3.12, CI 2.91-3.35), gravid hysterectomy (aOR 2.92, CI 2.47-3.44), maternal ICU admissions (aOR 2.28, CI 2.02-2.56) and preterm deliveries (aOR 1.47, CI 1.44-1.50), as well as adverse neonatal outcomes including low Apgar score (aOR 1.40, CI 1.34-1.47), NICU admission (aOR 1.65, CI 1.61-1.68), prolonged ventilation (aOR 2.18, CI 2.09-2.27), and neonatal seizures (aOR 1.85, CI 1.41-2.42) amongst others (Table 2). We report a significant increase in several adverse pregnancy and neonatal outcomes in singleton pregnancies conceived via IVF compared to those conceived spontaneously. Our data add to the clinical information available regarding pregnancy risks in this population, suggesting that Maternal Fetal Medicine specialist should be involved in the care of patients conceived via IVF.View Large Image Figure ViewerDownload Hi-res image Download (PPT)