Associations between artificial reproductive technologies (ART) and newborn size, as well as perinatal risk factors among singleton births in Vienna, Austria.

Abstract

Background: The use of ssisted reproductive technologies (ART) such as fertilization (IVF) and intracytoplasmic sperm injection (ICSI) has increased markedly during the last four decades. ART, however, is still discussed critically, as there is no consensus on whether these treatments have a negative effect on fetal growth or increase the risk of preterm birth, low birth weight, and perinatal complications. Objectives: The aim of this study is the analysis of association patterns between ART (IVF or ICSI) and newborn size, preterm birth rate, and the mode of delivery. Sample and Methods: In this single-center medical record-based study data concerning the conception mode (spontaneous versus IVF or ICSI), preterm birth, newborn sex and size, child presentation, delivery mode, labor induction as well as parity, maternal age, body height, weight, and gestational weight gain of 5867 singleton-term births taking place in Vienna from 2015 to 2023 were included. 178 newborns (3.0%) were conceived by IVF or ICSI. Results: ART (IVF or ICSI) increased the risk of preterm birth by a factor of 3.4, and the risk of emergency cesarean section by a factor 2.3. ART was not independently associated with newborn size as well as breech presentation. The most important factor for newborn size was the gestational week of delivery, but also maternal parameters such as body height, gestational weight gain, and age. Conclusion: Preterm birth is a major cause of small newborn size and complications at birth. Therefore, ART can also be interpreted with caution as an indirect risk factor for small newborn size with all its long-term consequences.