Outcomes of Very Preterm Infants Conceived with Assisted Reproductive Technologies

Abstract

To compare mortality and early respiratory outcomes of very preterm infants conceived via assisted reproductive technology (ART) vs spontaneously. We identified inborn infants (July 2014-July 2019) with gestational age <32weeks (n=439); 54 cases were ART conceived. Spontaneously conceived controls (n=103) were matched by multiple gestation status and gestational age. Primary outcome was 1-year mortality. Secondary outcomes were receipt of respiratory support and supplemental oxygen at 7 and 28days and 36weeks of postmenstrual age. We evaluated the association between conception method and outcomes by logistic regression, with adjustment for sociodemographic status. Women who conceived via ART had increased rates of prepregnancy and gestational diabetes, and no differences in rates of hypertensive disorders. Infant 1-year mortality was not different by mode of conception (ART 11.8% vs spontaneous 7.1%, P=.49). Infants conceived by ART were less likely to receive respiratory support or supplemental oxygen at all time points, but this relationship only reached significance for receipt of oxygen at 28days (ART 20.8% vs spontaneous 39.0%, P=.03); this remained true after adjustment for race/ethnicity and socioeconomic index. When controlling for gestational age and multiple gestation status, very preterm infants conceived following ART had similar outcomes as those conceived spontaneously.